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Neurology  (Expert Forum)
 | 
Whats happening to me??
Answered by
Lama Chahine, MD - Neurology
Cleveland Clinic Cleveland - OH
This forum is for questions and support regarding neurology issues such as: Alzheimer's Disease, ALS, Autism, Brain Cancer, Cerebral Palsy, Chronic Pain, Epilepsy, Fibromyalgia, Headaches, MS, Neuralgia, Neuropathy, Parkinson's Disease, RSD, Sleep Disorders, Stroke, Traumatic Brain Injury.

Whats happening to me??

by crazycow, Oct 31, 2009 08:41AM
Hello there,

I am a 23 year old female who is currently suffring from very strange visual disturbances.

I have had a lot of headaches over the past year, I would say that I have 3-4 headaches a week. I also suffer with neck, shoulder,scalp, upper back and jaw pain. I assumed these symptoms were just due to tension but I am now wondering if there is another problem. Over the past 3 months I have been having a lot of strange visual problems, they range from a random flash of light now and again to a constant sence that there are black dots moving in my peripheral vision. Sometimes when I move my head from one side to the other there are strange bright dots that follow my eyes in a line as i move my head. Sometimes there are just lots of little dots and flashes. I dont know whether this is a migraine because ive heard that occular migraines only last around 30 mins and sometimes I have this for days, its quite mild though, not enough to stop me going about my daily bussines. I also sometimes have a little sharp pain in my left hand and twice now I have fely like I cant swallow, I was told it may be TMJ.  I have had a full eye exam, my blood pressure is 100/65, I am not overweight at all, I do suffer with a lot of anxiety and im terrified of having a stroke. Could these visual disturbances be a sighn that I was about to have a stroke?
Thanks.

by Lama Chahine, MD, Nov 01, 2009 02:01PM
Thanks for using the forum. I am happy to address your questions, and my answer will be based on the information you provided here. Please make sure you recognize that this forum is for educational purposes only, and it does not substitute for a formal office visit with your doctor.

Without the ability to examine you and obtain a history, I can not tell you what the exact cause of your symptoms is. However I will try to provide you with some useful information.

There are several causes of headaches. Headaches can be divided into primary and secondary. Primary headache disorders are headaches without a direct cause. These are diagnosed after secondary causes have been excluded. Secondary headache disorders are due to an underlying problem, there are many many causes but some include medication side effects, systemic illness, nervous system infection, tumors, bleeds in the brain or clots in the veins of the brain, and others. Secondary causes of headaches are most often excluded with a combination of history, physical examination, imaging of the brain (ideally an MRI, and sometimes other types of MR imaging such as MRA and MRV), and in some instances, other tests.

Primary headache disorders are much more common than secondary ones. There are several primary headache disorders.  For example  migraines, which usually a pulsating throbbing one-sided pain with nausea and discomfort in bright lights that lasts several hours. As you mention, in some people, migraines are associated with visual symptoms.Vision symptoms may include transient vision loss, flashes of light in the peripheral visual field, or other similar symptoms lasting usually 30 minutes or less. Headache may or may not begin within 60 minutes and is often one-sided, throbbing, and may be associated with nausea and light-sensitivity.

The description you provide does not sound like typical stroke symptoms; migraines can VERY RARELY be associated with stroke, but again this is rare, and much more commonly, visual symptoms are just part of the migraine disorder.

Without further information about your headache, it is difficult to provide you with adequate information. However, it is important for you to understand that if you have not experienced headaches in the past and you are now having new head pains, seeing a neurologist is a good idea, just to make sure there is nothing serious causing this pain. Imaging of the brain and sometimes then neck may be indicated depending on your exact symptoms, your physical examination, and other factors. Headaches are highly treatable, and it sounds like you have a high headache frequency. Evaluation by a neurologist is recommended; medications to prevent the headaches from occurring, in addition to medications that would abort the headache should it start, can be highly effective. Evaluation by an eye doctor would be beneficial as well, particularly since some of your symptoms last for days which, as you mention, is not the typical occurrence with migraines.

Thank you for this opportunity to answer your questions, I hope you find the information I have provided useful, good luck.
Member Comments (2)

by redkim, Nov 06, 2009 01:16PM
Crazy Cow, I get migraines with visual disturbances, start as black dots and turn to what look like I am looking through a prisum.  I also have Chiari malformation which can cause: difficulty swallowing, neck pain, shoulder pain, there is a message board here for Chiari, and MRI and nurological testing is the only way to know for sure.  

I suggest an MRI anyways because of the headache problems.
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