Get your health question answered instantly from our pool of 18000+ doctors from over 80 specialties

178 Doctors Online
Doctor Image
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

I will be looking into your question and guiding you through the process. Please write your question below.

Suggest treatment for persistent scintillating scotoma

Answered by
Dr.
Dr. N. K. Misra

Ophthalmologist

Practicing since :1977

Answered : 1231 Questions

default
Posted on Mon, 21 Nov 2016 in Vision and Eye Disorders
Question: I have been having for the last year an almost daily occurrence of scintillating scotoma. It is usually always in the early morning, after getting out of bed, and before I eat breakfast. Most mornings I start out with a couple of hours on the internet, reading news stories and visiting Facebook. I find myself often bending forward toward the screen with my neck flexed. Once in a while I take magnesium supplements and it goes away soon thereafter. I have a history of ophthalmic migraines with aura. In those days, I would often have a peripheral vision deficit and a lingering basal headache afterward with malaise. The current scotomas do not have an associated loss of peripheral vision, no headaches either during or after the episode.
doctor
Answered by Dr. N. K. Misra 15 minutes later
Brief Answer:
Migraine.

Detailed Answer:
My Dear,
Thanks for sending your query to us.
This is a variant of migraine.Appearence of different types of scotoma and variability of pain may always occur.
The attacks may be precipitated by hypoglycemia,and strain,physical or mental.
This is to be treated on the lines of migraine,along with precautions like avoidance of physical and mental strain.
Above answer was peer-reviewed by : Dr. Prasad
doctor
default
Follow up: Dr. N. K. Misra 1 hour later
Most of these occurrences are in the early morning, just after getting out of bed and before consuming any food. Therefore, I can understand how blood sugar may have something to do with it. However, I have had these scotomas at variable times of the day when meals would seem to have little to do with it. Can light stimuli, either sunlight or the light from a computer screen stimulate such phenomena? Do you have any recommendations for eliminating the scotomas or reducing their frequency? Are there any vitamin or mineral deficiencies that you might attribute these symptoms to?
doctor
Answered by Dr. N. K. Misra 8 hours later
Brief Answer:
Migraine.

Detailed Answer:
My dear,
Thanks for getting back to me.
This is common in migraine to have scotoma at variable times.I have had patients who after 10 pm dinner woke up with migraine at 2 am.If there is consistency in timing,that points to some definite cause.
Avoiding these attacks has been a challange.The exact reason how it is triggered on is not specific,so it can vary from person to person.Tofu,chocklate and banana have been reported to trigger the attack,watch their intake and attack if they coincide.
Physical and mental stress is one trigger.So avoid excessive stress and strain including exposure to extreme weather conditions,heat or cold.Hypoglycemia being another stress and most of the time when you are over worked and do not have time to eat,that is the perfect recipe for attack.
Proper ,good diet with vitamins and minerals,exercise and rest including yoga and medication where required ,have shown very prompt response as I see routinely in my practice..
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
default
Follow up: Dr. N. K. Misra 1 hour later
I realize that this malady is difficult to pin down, in terms of its causation....which is really what I have been hoping to discover in writing to an expert. I guess I have always known that it is a form of migraine. In closing, I would ask if you think the fact that these scotomas are more frequent than even a year ago is any reason for concern. As I said, there is no numbness of face or extremities, no headaches during the episode or as a prevailing after- effect, no loss of peripheral vision or other visual sequelae. I do not feel that I am under any undue mental or physical stress. I am retired and have no work-related stress, nor any relationship or financial hardships. Is there any reason that the occurrences have become more consistent, and should I seek any medical treatment for them. Up until now, I have never used any medicine of any kind for migraines.
doctor
Answered by Dr. N. K. Misra 14 hours later
Brief Answer:
Migraine

Detailed Answer:
My dear,
Good of you to get back to me.
Usually the frequency of attacks go down with age or pain varies,at times there is no pain,and only scotoma.
We consider this as a part of life style management issue.Many patients respond to lifestyle management.Since you do not have apparently such stressful issues,there is no harm in having medication to control the problem.Though the treatment is long but most patients respond well to the treat.
Disease pattern varies with time,many of my patients have periods of 10 to 15 years of remission,even without treatment.
Let us decide about having treatment and get rid of the problem.
Above answer was peer-reviewed by : Dr. Prasad
doctor
premium_optimized

The User accepted the expert's answer

Share on
Question is related to
Diseases and Conditions ,   ,   ,  
Drug/Medication
Medical Topics

Recent questions on  Magnesium

doctor1 MD

I have been taking Exforge HCT 5-160=12.5 mg for 12 months and my blood tests results show that I am lacking in salt and I am anaemic. I have never had these conditions before. Could these be caused by Exforge. For the past week I have been taking Exforge 5.80 mg until my next blood test at the end of January.

doctor1 MD

I am 49 years old, and for the past year, I have noticed white bumps on my face. Some are very small, but one is quite noticeable. I am not sure, could it be fat deposits? I have put on 20 pounds in the past year, and I have a problem with alcohol,low magnesium, and low platelets. Is this a side affect?

doctor1 MD

I am 46 years old and had a partial hysterectomy at 33 years. I have had 6 pelvic surgeries after the birth of my only child. Currently I am on 200 mg bio identical HRT Progestrone and are taking 100mg of DIM to remove oestrogen dominance. I am on 20 mg of Prozac and take magnesium Malate Chelate and Vitamin B complex( to help with fibromyalgia). I am going through perimenopause and have noticed over the last few months that my urine smell has changed from occasionally a sweet smell to now a consistent foul stench. Is this perimenopause or Prozac? I am in no pain, although I have had bladder problems for many years due to adhesions and position of bladder from prolapsed and surgery. Why does my urine smell horrendous and offensive?

doctor1 MD

Sir, my husband has menerias desease and white matter hyper intencities in the brain. nov 10 first he had seizure from there he is taking eptoin 300 mg/day, epilive 1000mg/day, lobazyme 10/day pl. advise us what are the side effects of these mediciens. How long those are to be continued.

doctor1 MD

I am a 72 year old woman. For the past week I have been getting excruciating thigh muscle cramping thinking it was sciatica . My doc doesn't have office hours today and I want to begin taking magnesium supplement. What is the safe dosage?

doctor1 MD

This is a follow-up to our chat of a few days ago re magnesium to alleviate intense muscle spasms in my thigh. It seems to be helping along with the 2mg Tizanidine . I have spoken with my internist and he agrees that I should see an orthopedist to...

doctor1 MD

I've been suffering from diverseretulitis since 7th December,went to clinic, on 12..Received antibiotics,taking miralax .Have not had BM since 6th...can I saftey take something quick acting like magnesium citrate???????THANKS