One of the most common health conditions is migraines. It can be characterized as a series of frequent headaches caused by changes in the nervous system, making it a neurological condition. People with migraines may go through four stages, including prodrome, aura, attack, and postdrome. Note that not every migraine patient may experience all the stages, as the condition manifests uniquely in each individual.
Migraine auras are the sensory symptoms a migraine patient feels before or during a migraine attack. One study found that an aura can be an effect of neuronal and glial depolarization spreading across the cerebral cortex. This action activates the trigeminal afferents and produces inflammatory changes in the meninges. The result: pain.
25% of migraine sufferers or 1 in 5 people with migraines experience auras. They may last up to 60 minutes or less. Auras are commonly known to be visual but can also manifest as auditory, somatosensory, or motor disturbances.
Given this insight, let’s look more deeply into one type of visual aura called a scintillating scotoma.
What Is Scintillating Scotoma?
This is a type of aura that causes disturbance to one’s vision. The visual disturbance is initially small but gradually grows into an indefinite size and then simply disappears before an actual migraine attack occurs. This type of aura preceding a migraine is common among younger people.
But there are also instances wherein the aura never crosses over into the pain phase of migraine. This means that there is a less severe form of damage taking place in the brain. Scintillating scotomas without pain are most likely experienced by those who are aged 50 and up.
The word “scintillating” implies “shining or sparkling.” Meanwhile, the word “scotoma” indicates “partial loss of vision or a blind spot in one’s visual field.” You may be having this visual aura if you’re suddenly experiencing subtle flickering near the center of your visual field. The flickering may even take up half of the space of your visual field. Some patients report seeing stimulating zigzag-like or geometric patterns.
Causes and Triggers
The most common cause of this type of visual migraine aura is cortical spreading depression (CSD). CSD is a gradual propagated wave of depolarization leading up to the suppression of brain activity. It can also be defined as a “wave” of “depression” wrapping the cortical part of our brain, called the cortex, which can be outside of it. We can compare this wave to a blackout or power resets and outages. When this blackout passes through the visual processing part of our brain, it produces odd visual symptoms.
Each person has his or her unique physiological makeup. That is why scheduling regular checkups can help you determine what triggers your scintillating scotoma. Here are its other causes and triggers:
Hormonal Imbalance
This trigger is particularly common in women. Estrogen hormone levels go up and down, most especially during a woman’s menstrual cycle. Some of the common hormonal conditions can cause unexplained weight gain or loss, constipation or more frequent bowel movements, decreased sex drive, increased hunger, and more. Fluctuating hormone levels can also be a contributing factor to migraines.
Migraines are believed to have a connection to the female hormone estrogen. Estrogen is a type of brain chemical that can stimulate the sensation of pain. When estrogen level decreases, a headache followed by a scintillating scotoma occurs.
Pregnant women and those who are in their menopausal stage are also believed to have visual or ocular migraines.
In a study conducted by The Journal of Headache and Pain, researchers found out that there are various symptoms as to why pregnant women get headaches. One of them is that they are caused by neurological symptoms like visual and sensory disturbance. Additionally, the most common visual disturbance in the participants was reported to be a scintillating scotoma.
Migraine intensifies among women approaching menopause, according to a study from The University of Cincinnati Academic Health Center. Likewise, Dr. Albert Pang, an optometrist, states that women experience vision changes due to hormonal imbalance. Menopause causes a woman’s estrogen and progesterone levels to drop. As a result, women in their menopausal and post-menopausal stage of life may have trouble reading fine print or looking at something close up without eyeglasses or other products that can assist in better vision.
Diet
A scintillating scotoma can also be caused by the foods we eat. Needless to say, if we are not careful about our dietary consumption, certain illnesses may develop as a result. For example, migraine patients are susceptible to some kinds of foods. Each patient is unique, so you must know which food triggers your migraine to avoid its onset.
Stress and Fatigue
Stress is characterized as any event in our life that causes us to be agitated or frustrated. A normal response to stress is fatigue. This is the feeling of exhaustion or lack of motivation. While stress and fatigue are something normal that we may encounter in our daily lives, we still have to be careful how we deal with them. If we don’t take action, they may interfere with our sleep and vitality.
Going through stress and fatigue may take a toll on your health and may even lead to migraines. A 2017 study found out that the most common trigger for migraine patients is perceived stress. In addition, 57.7% of patients in this study indicated fatigue as a headache trigger.
How to Prevent Scintillating Scotoma and Relieve Its Symptoms
Here are some of our suggestions on how you can prevent scintillating scotoma.
Eat a Balanced Diet
Our body needs a sufficient amount of nutrients, which typically come from whole, fresh foods. Moreover, it is important to pay attention to your intake of the following foods:
Caffeine
This is a typical substance that is included in many drinks like coffee, tea, or even soft drinks. It is considered as a central nervous system stimulant, giving people the energy they need to get through the day. However, caffeine withdrawal can cause headaches and may even result in visual hallucinations or temporary blind spots.
Fast Foods
Yes, eating out at a favorite fast-food restaurant can be convenient. However, the foods at these places are usually full of preservatives and are artificially enhanced with flavor, more particularly monosodium glutamate (MSG). In fact, MSG can trigger visual headaches and discomfort.
Chocolate and Red Wine
Both chocolate and red wine are known to carry many health benefits. However, too much consumption of either can be a potential migraine trigger. These foods possess a certain amino acid called tyramine. Eating high-tyramine foods can spike blood pressure, which can likewise lead to severe headaches or migraines.
Citric Acid
People with visual migraines often feel sensitivity to citric acid. This compound is commonly found in fruits such as oranges and lemons, but it is also made artificially and included in many products to preserve their freshness and shelf life. Do avoid artificially-added citric acid whenever possible. If however, even the natural citric acid causes sensitivity, you should try to limit citrus-rich fruits altogether. Indeed, citric acid can cause one’s level of oxidative stress to increase, leading to migraines. And a recent study corroborated that sentiment by reporting that migraines can be a response to the brain’s oxidative stress.
Artificially Sweetened Foods
People who are conscious about their blood sugar levels or want to keep their sugar intake low tend to choose meals with artificial sweeteners. However, artificially sweetened foods may contain aspartame. This is a substance that is 200 times sweeter than average cane sugar and is currently also known to be a neurotoxin. Headaches may continue to surface with continued aspartame intake. A study from the American Headache Study even presented studies indicating that aspartame exposure was associated with increased headache frequency.
Manage Your Stress Levels
Stress causes the shifting of molecules and hormone levels in our body. There are countless ways you can minimize stress. You can exercise, do yoga, or go for walks for at least 30 minutes a day. Spending harmonious time with your loved ones also relieves stress.
Avoid Long Hours Facing the Computer
This can be a bit difficult for those who rely on their computers for their work. However, taking a break for a few minutes can be helpful. Just apply the 20-20 rule. This entails you to stop every 20 minutes, look away from your computer, and stare into something 20 feet away.
Follow a Regular Sleep Routine
Disturbed sleep or lack thereof is a common migraine trigger. In fact, a 2016 study showed that 30% to 50% of migraine patients reported sleep disruption as a trigger to migraine attacks. Getting at least eight hours of sleep not only prevents an ocular migraine aura but also brings several health benefits. When you get adequate sleep, you reap better concentration and productivity, improved immune function, and can even maximize your athletic performance.
Rehabilitation Aids
Scotoma does not bring serious vision problems if located at the outer edges of the vision field. On the other hand, if it affects the central vision field, it cannot be treated with eyeglasses, contact lenses, or even surgery. Depending on the patient’s condition, a doctor may recommend various tools to cope with scintillating scotoma.
- Apply filters to minimize the glare from your computer screen
- If you’re fond of reading ebooks, make sure to enlarge the font size
- Try audiobooks, newspapers, or magazines as an alternative
- Use programs on your computer or smartphone that convert text to speech
- Use handheld magnifiers, stand magnifiers, or magnifying eyeglasses to see things more clearly
- Choose talking clocks or scales over regular ones
- Apply large-font modes on your phone keypads and watch faces
The most important course is to regularly consult your ophthalmologist to know if your condition is getting better or worse. Most likely, the professional will prescribe customized lifestyle measures or medication that can help you. Using an ear device migraine can be a preventive therapy against migraine, as well as a scintillating scotoma.
Final Thoughts
A scintillating scotoma is a common visual aura that may precede migraine attacks or simply occur without a headache. During an episode, patients often report having a visual disturbance, particularly seeing flickering lights or zigzag-like patterns, lasting for about an hour or less. What causes and triggers this migraine aura varies from person to person.
