Symptoms and methods of treatment of ocular migraine

1 Etiology and pathogenesis of

development Currently, the exact reasons why a person can develop an ophthalmoplegic migraine are not established. Many doctors note that in reality migraine is not an ophthalmic problem, but a neurological and vascular disorder that is accompanied by a malfunctioning of a special visual analyzer located in the occipital lobe of the cerebral cortex. At present, a number of predisposing factors have been identified that are capable of provoking attacks of ocular migraine in certain circumstances. Such predisposing factors include the following:

• acute reactions of the body to weather changes;
• frequent stress and depression;
• non-compliance with sleep patterns;
• fluctuations in the hormonal background;
• smoking;
• inhalation of acute odors,
• emotional outbursts;
• fluctuations of atmospheric pressure;
• excessive physical exertion;
• the use in food of some products;
• hypoxia;
• use of certain medicines;
• prolonged eye contact with flickering light sources.

Among other things, a variety of diseases associated with disorders or changes in the structure of arteries located in the brain, for example arteriovenous malformation, can become a provoking factor for the development of migraine. In addition, ocular migraine can be a consequence of impaired blood circulation in the optic nerve zone. There is an opinion that ocular migraine can be a genetically determined disease, but at present this theory has not been scientifically confirmed. Often, migraine is observed in adolescents during the transition period, but then the body "overgrows" it, so at a later age, such health problems are not observed. The development of atrial scotoma in adolescents is associated with the rapid growth of the body, as a result of which the blood and nervous system do not have time to form properly, which causes specific symptomatic manifestations.

2 Clinical picture of

As mentioned previously, the symptoms of ocular migraine always include the appearance of visual auras, i.e., photopsies. Such visual defects, as a rule, are seen immediately in both eyes. In the process of developing ocular migraine, a visual aura of a small size first appears, which gradually expands towards the edges of the visual field. In rare cases, such a pathological visual image is colored in different shades. As the migraine develops, the luminous images of the aura can be replaced by the fallout of separate areas of the visual field, and often such a site can occupy half of the field of view.

In very rare cases in people with developing eye migraine, the aura has the form of a non-glowing formless object, and hallucinations. During a hallucination, a person can see a variety of images, often surrounded by a warm glow. Such symptoms can frighten a person, aggravating his situation. In the retinal form of ocular migraine, as a rule, a central aura develops, which can be of the most varied magnitude and form.

Among other things, the common manifestations of ocular migraine include ptosis of the upper eyelid, impaired pupillary function, and sometimes temporary strabismus. As a rule, after the appearance of symptoms on the part of the eyes, after only 5-15 minutes, a headache begins to build up, which is localized in the fronto-eye area of ​​the face. Pain, as a rule, is of a pulsating nature and can grow from 30 minutes to 1.5 hours. In rare cases, the symptoms of an attack of the ophthalmoplegic migraine form can last about 6 hours. During the peak of the attack, patients often experience such intense pain that they can cause nausea and even vomiting. Very rarely, ocular migraine can occur without a headache, but this variant of an attack is infrequent. Symptoms from the side of the eye can persist for several weeks, but then pass almost without a trace.

3 Diagnostics of

Given that eye migraine is not an ophthalmic problem in order to conduct targeted treatment, it requires a thorough diagnosis and identification of the underlying cause that triggers an attack. The examination should be as comprehensive as possible, since migraine is more a neurological problem. To confirm the diagnosis, a detailed history, examination of the pupil response, external examination of the eye, conducting an MRI of the brain, conducting tests to determine the boundaries of the visual field, assessment of motor activity and volume of the eyeball, ophthalmoscopy are collected. Despite the fact that for a long time the eye migraine was a problem of ophthalmology, the study made it possible to identify the need to assess the patient's condition by a neurologist, endocrinologist and cardiologist.

After a comprehensive assessment of the patient's condition and the root cause of the onset of an attack has been identified, directed treatment with medications can be prescribed, and recommendations for first aid and prevention of seizures in the future are given. As a rule, in order to treat pain during a migraine attack, doctors prescribe the following drugs:

• Aspirin;
• Paracetamol;
• Triptans;
• Anti-inflammatory drugs.

Special attention should be paid to preparations belonging to the group of triptans. This is a relatively new means, which are designed specifically for the management of migraine attacks. These drugs are especially useful to people who suffer from protracted migraine attacks, whose treatment with conventional pain medication does not bring good results. The thing is that tryptans contribute to the narrowing of the vessels, rather than stimulating the cessation of painful pulsations, which is noted in all patients with migraine. It is worth noting that drugs on the healthy blood vessels belonging to the group of triptans do not have any adverse effect. In addition, they have a positive effect on receptors that control inflammation and the development of headaches, which allows you to quickly stop the attack. The third vector of the action of triptans is the narrowing of the sensitivity of the trigeminal nerve nucleus, which helps to eliminate the pain syndrome.

In order to reduce the frequency of migraine attacks, patients should avoid stressful situations, sleep at least 8 hours a day, show moderation in terms of physical and emotional stress, and also try to reduce the consumption of foods and drinks containing a large number of preservatives, dyesand other chemical components. Nutrition should be given attention, since such products as red wine, nuts, cheese, etc. can cause migraine attacks.