Ocular Migraine Stroke Connection

What is modern research telling us about the ocular migraine stroke connection?  In order to answer that question, we need to look at the controversy over just what ocular migraine (sometimes misspelled occular migraine) are.

Just what is Ocular Migraine?

The confusion comes from the fact that the term "ocular migraine" is no longer used in the official classifications from the International Headache Society.  That means that there is no official definition - and people use it in different ways.

In my discussion of ocular migraine here, I found that the term was (at the time) most often used to refer to retinal migraine.  For a quick overview of retinal migraine, read 5 Signs You have Retinal Migraine.

Often, however, in common conversation, people who talk about ocular migraine are referring to a migraine attack which involves visual disturbances.

There are actually several types of migraine that involve various types of visual disturbances, including visual auras, hallucinations, and blindness.  Sometimes it refers to migraine with visual disturbances but no headache (sometimes called silent migraine).  Check out this article from the Mayo Clinic about ocular migraine.  Speaking of migraine with aura, another article points to another ocular migraine stroke connection - a stroke could be confused as a migraine in the first place.

Ocular Migraine and Stroke

So where does that leave us when we're talking about the ocular migraine stroke connection?

First, we need to remember that we're only starting to understand the stroke-migraine link.  It's still unclear exactly why there is a connection, and just how strong that connection is.

If we're talking specifically about a ocular migraine stroke connection, what types of migraine involving visual disturbances are most connected to stroke?

Migraine and Stroke

There is evidence that all types of migraine may increase your risk of stroke, not just migraine with visual disturbances.  However, some studies have pointed to a slightly higher risk for those with certain types of migraine.
  • Basilar Type Migraine:  There has long been a concern that those with basilar migraine are at an increased risk of stroke.  These types of migraine involve many symptoms, including two sided visual disturbances (including double vision) and temporary blindness.
  • Migraine with Aura:  If you have visual aura during a migraine attack, are you at a higher risk of stroke?  Some studies say yes, others say that the difference isn't very significant.  A study in 2010 suggested that women with migraine with aura were less likely to have significant disability after stroke.  A genetic link may explain why some with migraine and aura have a higher risk.  Check out this back issue of HeadWay for more on the link between migraine and stroke.
In the end, it appears that there's not only an ocular migraine stroke connection (so-called), but also a link between many types of migraine and stroke.

Note:  Some types of migraine mimic the symptoms of stroke, such as Familial Hemiplegic Migraine.

What should I do?

First, be sure you have a proper diagnosis.  If you've received a diagnosis of ocular migraine, you may need to find a specialist who can diagnose you according to the IHS classification.  Either way, be sure you get a proper diagnosis if you have a symptoms that are worse than normal or different than normal ("normal" meaning that you've already talked to a doctor about it).

Second, so far the research tells us that this is no reason to panic.  In most cases, your risk of stroke is not skyrocketing - in other words, this is simply another risk factor, not a sure-sign you'll have a major stroke.

So treat this as any other risk - and focus on staying healthy and lowering whatever risk you can.  Find treatment for migraine from a specialist.  Don't smoke.  Eat healthy and keep your weight at a healthy level.  Avoid illegal drugs.  And ask about how medication you are taking increases your risk.

For more, read Migraine and Heart Disease: 7 Critical Things to Know Now.