2023-08-01 13:36:51
I am a rare exception: a migraine sufferer without a migraine! Only regarding 20 percent of all patients with a migraine have an aura before the attack. That is, they experience a type of perceptual distortion that lasts between 20 and 40 minutes and is unusually diverse: there are visual or speech disorders, numbness or pins and needles on the skin, rarely olfactory disorders.
These distortions are not created in the eye or on the skin, but in the brain. The nerve cells there suddenly become overexcited for unknown reasons – they fire meaningless signals. This excitation pattern runs like a La Ola wave over parts of the cerebral cortex, such as the visual center. And that’s where a visual aura, the most common form, is created.
It begins with a small, shimmering dot on the left or right of the field of vision. However, this dot does not flicker in the left or right eye – it flickers in both eyes, on the left or right side respectively. The dot has a colorful, jagged, shimmering edge, gets bigger and bigger and finally takes up half of the face: those affected are temporarily blind on one side. Then the visual disturbance slowly recedes – and the aura is gone.
Now the second part of the migraine attack begins for most people: the pain. For these patients, the auras have the advantage of an early warning: They can prepare for the attack – and they can take the medication quickly and therefore more effectively. However, this does not apply to the drug group of triptans. These are vasoconstrictive, anti-inflammatory and pain-relieving agents that are often used in acute therapy.
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Now comes the pain – or not. In rare cases, with a few patients, nothing follows the aura. Neurologists also speak elegantly of a “migraine sans migraine”, of a migraine without a migraine. I belong to this enviable group myself. Enviable because the aura is quite beautiful to look at, which is why it is also referred to as “Alice in Wonderland Syndrome” – and in the past was often interpreted as a supernatural revelation.
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