Migraines are common in multiple sclerosis, but mine aren’t

Migraines are quite an experience. People who have them wish they didn’t. I occasionally do, but I’m hesitant to compare myself with others. I’m even reluctant to use the word “migraine” to describe mine, because while I have many of the symptoms of a migraine, I don’t have any of the head pain.

Mine are referred to as migraine aura without headache, or “silent” migraines. While the experience is unpleasant, I’ve been told it’s very different from those with pain. A particularly cynical friend who routinely has them told me the difference between our experiences is like having a cavity filled with and without anesthesia. He stopped short of saying I was lucky, but it still feels a little dishonest to say I have migraines without prefacing it with the word “silent.”

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Recently, I commented that I tend to attribute every bad thing in my life to multiple sclerosis (MS), but in this case, I don’t think I’m wrong to do so. Headaches of any sort are rare for me, but I still sometimes have them, mostly because of my sinuses. Silent migraines, and their accompanying symptoms, however, are a new experience for me that started after I was diagnosed with MS.

Migraines are relatively common in people with MS. Approximately 1 in 4 people with this disease report having them, but the relationship between the two conditions isn’t fully understood. Damage to certain structures of the brain, inflammation related to MS, and even certain MS medications are suspected of playing a role, but like so many things about this disease, the exact cause is still somewhat of a mystery.

My silent migraines are usually preceded by a visual aura. If my eyes are closed, it feels like someone is shining a flashlight at one side of my head. Occasionally, I’ll see a bright dot of light that’s usually blue or green, as though I’d seen a bright flash of light and had the image burned onto my retina.

On two occasions, I’ve had what is called scintillating scotoma. This could be a blind spot, a flickering point of light, or something you might see in a kaleidoscope. Both times, the ones I experienced were like sawtooth rainbows in the shape of a backward “C.” The first time was more than a little unnerving, but by the second time, I knew what to expect and just enjoyed the light show.

When my silent migraine is in full swing, I have a number of the usual symptoms. My senses become extremely sensitive and make me want to avoid light, noise, touch, and even smell. My pulse pounds in my head, to the point that I feel like I can hear my own heartbeat. My vision is blurry, but maybe that’s because when my eyes aren’t closed or protected by a dark room, they’re only opened in narrow slits. All of that steals my energy and leaves me fatigued. I can’t imagine what it’s like with pain.

When I first described the symptoms I was having to my neurologist, he looked at me for a second, then told me that I had perfectly described a migraine, but without the headache. He originally prescribed a medication to lower my blood pressure, which would dilate the blood vessels in my brain. When this didn’t work, he recommended a drug called sumatriptan, which specifically treats migraines and is taken as needed. It seems to be working well, but the directions indicate that it shouldn’t be taken until the pain starts, so I feel like I’m winging it.

As unpleasant as it can be, our pain response is there for a reason. Pain lets us know that something is wrong. It’s our cue to do something to alleviate it. Believe me, I feel fortunate to not have the pain, but I almost feel like I’m being robbed because I’m having to rely on other cues to know when to treat the condition.

I don’t have a particularly high pain tolerance — just ask my wife. A migraine aura without a headache is frustrating and even a little scary at times, but I seriously doubt I could stay silent if I’d have a typical one. I hope I don’t have to find out.

My hat is off to all of you who routinely deal with them. This MS symptom really is “all in your head” — and I’m sorry.

Note: Multiple Sclerosis News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Multiple Sclerosis News Today or its parent company, Bionews, and are intended to spark discussion about issues pertaining to multiple sclerosis.