Ophthalmic migraine

Our Global Medical Institute center focuses on three categories of migraine: frontal migraine, occipital migraine and temporal migraine.

Global Medical Institute makes a point of distinguishing between the different types of migraine, depending on the starting point of your migraine pain.

As you can see, it's very important for you to know where your pain starts, so that we can offer you the right treatment. A treatment that will soothe you, calm your pain and reduce or even eliminate the symptoms of your migraine.

In these few lines, we'll give you the facts about ophthalmic migraine, so that you can find out more.

Why is it important to locate the starting point of your pain? What is an ophthalmic migraine? What treatments are available at our Global Medical Institute center?

This section will help you make a free and informed choice.

The importance of localizing ophthalmic migraine pain

As mentioned above, it's very important for all our patients to be able to locate the starting point of their pain.

Indeed, if you can locate the starting point of your pain expression, our surgeons will be able to help you treat your migraine, whether temporal, occipital or frontal.

At our Global Medical Institute center, we focus first and foremost on the starting point of the pain, before proposing any medical or surgical treatment.

Sometimes, an initial consultation can be carried out via teleconsultation from the comfort of your own home: Global Medical Institute's specialists will be able to explain whether your suffering can be relieved by our minimally invasive approach.

By focusing on the location of the pain, we give ourselves the means to treat your symptoms. That's why it's important for you to be able to locate it.

It Is important to get a precise definition of your migraine, but all our patients tend to get lost in the different types of migraines, denominations, definitions and so on.

Migraines are not easily defined, and there are many different types. Our neurologists specialize in the classification and treatment of migraines. Our surgeons specialize in treating the pain expression of your migraines.

The only important point to focus on is the location of the pain, in particular the point of pain onset. It's on the basis of this location that we can help you decide whether the pain is frontal, occipital or temporal.

If the starting point of the pain is consistent with the pinched nerve or vessels, if that's where the pain began: that's where our doctors and surgeons can act. We decompress the nerve and free it from the structures that are trapping it: these structures can be vessels, muscles, tendons, etc.

What is an ophthalmic migraine?

As mentioned above, it's important to get a precise definition of your migraine, but all our patients tend to get lost in the different types of migraines, names, definitions, etc.

An ophthalmic migraine is characterized by pain in the ocular region. In fact, many of you have experienced severe pain in this region during a migraine attack.

Finally, the “general public” tends to use the terms “ophthalmic migraine” and associate them, while scientists, particularly doctors and researchers, classify it as a common migraine or simply migraine.

Why “ophthalmic migraine”?

You tend to refer to an “ophthalmic migraine” when you suffer from headaches associated with frequent, impressive and painful pain in the eye region.

You feel pain "right down to the eye socket", and your eye feels as if it's being pulled. In most cases, however, an ophthalmological examination reveals nothing abnormal.

In reality, it's not an optical problem, but a sensation caused by the optic nerve during a migraine attack.

During this phase, known as the “aura”, painless signs of neurological origin appear: flickering dots, black spots in the visual field, sawtooth or rainbow patterns, etc. In some cases, your visual field may even be obscured. Your visual field may even be obscured (dangerous for motorists).

What causes ophthalmic migraine?

First of all, there is almost certainly a genetic component. Indeed, several members of the same family can suffer from "ophthalmic migraine". However, no gene has been identified.

There are many possible causes:

• Arnold’s neuralgia
• Menstrual cycle: before the onset of menstruation, there is a drop in estrogen levels, which frequently induces a migraine attack.
• Individual factors: worries, annoyances, overwork leading to stress which can trigger an attack, heavy physical or mental exertion.
• Weather conditions: wind, cold or sudden changes in temperature.
• Strong odors from certain plants or perfumes.
• Circadian rhythm disturbances (too much or too little sleep, staggered working hours, etc.).
• Sudden changes in light.

What are the symptoms of an ophthalmic migraine?

As mentioned above, migraines with auras are characterized by the appearance of visual disturbances (flickering scotomas, loss of vision), sensory disturbances (tingling, tingling around the mouth) and/or phasic disturbances (slurredspeech). These auras precede the migraine headache, which manifests as a pulsating headache often affecting only one side of the skull. It is accompanied by intolerance to light and noise, as well as nausea and vomiting. This violent headache, aggravated by everyday actions such as climbing stairs, can last from 4 hours to 3 days.

What treatments does Global Medical Institute offer for your ophthalmic migraine?

Medical treatment:

In all cases, resting in the dark, away from noise and light, will help prevent the attack from worsening.

Migraine treatment is based on avoiding triggers wherever possible.

Moreover, the earlier the patient takes his or her medication, the faster the attack will be relieved. Patients are advised to take 1g of paracetamol at the time of the aura, or a non-steroidal anti-inflammatory drug (NSAID) to limit the duration of the aura and prevent the headache.

If this is not enough, we recommend the classic migraine treatment: triptans, which can also be combined with NSAIDs.

If this initial medical treatment is not sufficiently effective, and in more severe cases, we may suggest amitriptyline, an antidepressant, antiepileptics or certain anti-hypertensives, or monoclonal antibodies to reduce the intensity of attacks (anti-CGRP). Or drugs not initially intended for migraine.

Your neurologist will be able to give you further information on medical treatments for your ophthalmic migraines.

Minimally invasive treatment:

In the case of ocular pain or “ophthalmic migraine”, we can diagnose your migraine, which can be relieved mainly by botulinum toxin infiltration or local anesthesia or cortisone, depending on the starting point of the pain.

Very frequently, ophthalmic migraines are linked to Arnold's neuralgia, the irritation of the greater occipital nerve or Arnold's nerve in the back of the neck. If infiltrations in the back of the neck prove positive (remission or significant reduction in pain for a few days or weeks), Arnold’s nerves can be decompressed to provide permanent relief from ophthalmic migraines.

Surgery for Arnold's neuralgia uses a minimally invasive approach, under a microscope, with a small incision in the back of the neck to free your Arnold’s nerve and relieve your pain for good.

Botulinum toxin is both a treatment (for a few months) and a test. Botulinum toxin injections can relieve frontal pain completely for 2-3 months.

After several sessions of botulinum toxin, you become a candidate for minimally invasive surgery to permanently relieve migraine pain.

An incision in the upper eyelid allows your Global Medical Institute surgeon to free the nerves. The scar is almost invisible, and recovery takes around a week. After 5 days, the threads can be removed.

Results in terms of migraine pain reduction are seen progressively over a period of 3-6 months, and are definitive.

Surgery for forehead or supraorbital pain is performed under local or general anesthetic and lasts around 1 hour. We do not cut or burn the nerve, but rather decompress it, freeing it from the structures that "jam" it.

Sometimes, an initial consultation can be carried out via teleconsultation from the comfort of your own home: Global Medical Institute specialists will be able to tell you whether your suffering can be relieved by our minimally invasive approach.