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Comment by pugworthy | Hacker News Reader

I rarely get the headache side of migraines, but I do get the visual aura fairly often. If over-stimulation is a factor, then certainly they are a bit self regulating since I have to just stop using the computer, stop reading, stop looking at my phone, etc. until it's gone.

If you've not had the visual migraine effect before, the impact is a bit like if you looked a bright light, then tried to read something.

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Very very interesting topic.

I was also used to suffer from the visual migraine as you describe it.

For another exemple, it is like looking at the phone in complete darkness with the phone brightness set to the maximum; but that effect in daylight with the screen set to low/normal brightness level.

Maybe I'm wrong, but the deductions I did from my issues was that it might be related to work conditions. For example, I used to have the computer screen at 90° of a window. And there was probably constantly a little bit of light reflexion on my screen. So it is not so much to be noticable or annoying, but for a full day it will exhaust my eyes and brain. And I would regularly have the issue at the end of the day.

Then, I changed of work and of light conditions, and I almost never got the issue anymore. (Still once in a while, but very very rarely compared to before)

Also, I discovered that there are a lot of good advice regarding the work environment that you should try to respect:

- no excessive room temperature (>21)

- no sun or light directly in front. No light reflexion from the back or side.

- room ambiant light the closest possible to the brightness of the screen

But, a point that could support the theory of this publication is that, when the issue arrived, it was often that I was feeling hungry for sweets and desperately looking for a snack.

Sounds like Ocular Migraines. I've gotten them now for about 10 years. Usually I get them in clusters after not having them for a few months.

Wish I knew if it were something more controllable.

For me it's a bright, shimmering little thing that grows over my entire vision over 30-45 minutes. When it finally subsides, I get a pretty awful headache for 1-2 hours. Ibuprofen fortunately does help with the headache, at least.

I had an occular migraine once. Scared the hell out of me. 95% of my field of view became blurred, and almost as if I was looking through extremely cracked glass. No pain or headache but I had an incredible sensation of pressure centered behind my eyeballs. By the time my wife drove me to the ER, it had subsided completely. Maybe an hour after the onset.

At the time, I was 4 weeks deep into a 6 week crunch (the worst of my career) where I was pulling successive 90+ hour work weeks. Have never worked over 40 hours since moving off of that project. Have never had an occular migraine since. Truly hope I never experience that again. I can't imagine going through them every few months...

My wife recently suggested that mine may be brought on by my seasonal allergies. I get them infrequently, but thinking back the timing is about right. I wish I’d kept a log.

I am not a doctor, but if I start to get one of those I chug a coke or two. Reading the paper, it seems this was one of their findings (one coke is 39g of caffeine). It says you need caffeine and glucose:

"Corticosteroids that stimulate gluconeogenesis, are amongst the most effective drugs for abortion of prolonged migraine attacks and status migrainosus148. Caffeine (>100 mg), on the other hand, has a beneficial (though small) analgesic effect, at least when used in conjunction with common analgesics149. Besides its suppression of transient receptor potential A1 (TRPA1) activity150, caffeine also stimulates cortisol secretion151,152 and, consequently, gluconeogenesis153. In addition, caffeine increases levels of free fatty acids and decreases insulin responses152, effects that are similar to the metabolic changes that occur during a migraine attack81."

Taking caffeine and sugar for a migraine is like taking cocaine for a tooth infection.

I do not usually get the headache part either but the visual part is epic.

The first time I got it, a few years ago, I thought I was having a stroke.

The visual area gets ripped in two by the diagonal, the two pieces move away and are replaced with a silver band. The picture stays more or less complete, but broken in two. The image kind of pulsates, or rather waves.

I was terrified the first time, then visited the ophthalmologist, did a tomography of my head and ended up at a neurologist. He was a specialist of migraines and told me that about 30% of migraines are without headaches.

My father has migraines, my younger brother too and both have headaches.

I had some other extasy-like migranes and I am usually exhausted afterwrds and sleep 10 to 12 hours straight.

I am lucky to have only a few cases a year.

I think the visual aura part can be different for many people. I also thought I was having a stroke -- in my case the entire center of my vision in both eyes disappears.

But the brain is used to that behaviour (center-dead-spot from optic nerve) and has a prebaked solution: average/blend the inputs from around the dead-spot.

However my migraine-visual-aura center-dead spot is about the size of a 12" laptop screen, which results in horrifically nauseating visual "blending" happening nonstop. I tried to look at a book once and the only words I could read were the first & last words on each line. I tried to read a car license plate and could only read the last letter.

When the rate at which I got them increased from 1/6mo to 1/6week, I got a prescription & haven't had one since.

> The first time I got it, a few years ago, I thought I was having a stroke.

That was my reaction as well.

It reminded me of looking through a kaleidoscope.

Luckily I’ve only had it occur a couple of times.

When I first had one many years ago, I thought detached retina, as my sister had them.

An interesting observation RE: the visual aura. My mother has had migraines for years, and just had some surgery involving anesthesia. Afterwards she had very frequent visual migraine auras along with a certain amount of post-anesthesia brain fog, which both lasted about 24-36 hours.

I tend to find that I first notice the visual aura because reading becomes significantly more difficult. I can still make everything out, but focusing on the words takes additional effort. This sometimes comes with some sort of visual artifacts, often things moving within my vision.

Unfortunately stopping my activity at the time is rarely enough to stop the onset, and this progresses into a severe headache. Taking ibuprofen and paracetamol, preferably with a caffeinated drink, at the first sign can reduce the intensity but I don't think I've ever managed to avoid it entirely.

I recently learned about ocular migraines, and what you’re describing could be that. https://www.mayoclinic.org/diseases-conditions/migraine-head...

I have the exact symptoms as you - no headache but visual aura.

I think my triggers are a lack of food/hydration and bright lights.

I’ve seen a doctor for this and he mentioned stress and foods containing tyramine (pickled and fermented foods, preserved meats and aged cheeses, asparagus, red wine, chocolate) as possible triggers.

See: https://www.webmd.com/migraines-headaches/tyramine-and-migra...

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