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What causes headache and visual aura while climbing the stairs?

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Posted on Mon, 9 May 2016
Question: I get a head ache climbing stairs. Sometimes there is an aura in my vision. Sometimes I start to to gray out.

I have run up a set of stairs after having just walked up stairs and seem to be OK.
I can mountain bike, swim, hike, rollerblade and exert myself at a high heart rate and not have a problem.
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Answered by Dr. Dariush Saghafi (4 hours later)
Brief Answer:
Interesting type of problem

Detailed Answer:
Good evening. This is an interesting problem to try and figure out since intuitively one might guess just the opposite might be the case. In other words by RUNNING up the stairs one would increase heart rate, increase blood pressure, release more adrenalin, in general there would be an increase in metabolic activity which seems to be consistent with increasing stress and this automatically seems to be consistent with generation of a migraine type of headache.

But in reality, just the opposite tends to happen. By increasing metabolic activity levels and kicking the baseline physiology into a higher gear there tends to be an interference pattern set up against overindulgence of the trigeminal nerve. This likely occurs by way of increasing brain levels and secretion of SEROTONIN which is a neurotransmitter that is known to act on receptors within brain structures that can SHORT CIRCUIT migraine headaches. This is the theory behind the idea of recommending more and higher levels of aerobic exercise to migraineurs.

When simply WALKING up stairs there is not nearly the same level of increase in metabolic and physiologic activity and in fact, by climbing stairs more slowly one could be facilitating the onset of migraines by increasing fatigue over the time period it takes to climb (not run) the staircase. When fatigue increases, velocity up the stairs slows down and this in turn can affect blood pressure causing it to drop dramatically in a way that may induce a rapid heart rate, lightheadedness, flushing sensations, and MIGRAINE HEADACHES (usually with aura). The dropping blood pressure is known as ORTHOSTASIS.

A positive correlation between the development of dropping blood pressure while a person is engaged in exercise activity or standing erect for a length of time (ORTHOSTASIS) and migraine headaches is known to exist. Therefore, when you climb stairs slowly you are facilitating the chain of events necessary to trigger the trigeminal nerve into action.

Bottom line--- DO NOT CLIMB STAIRS slowly....and if you don't feel like jogging up the stairs then, TAKE THE ELEVATOR! LOL!

And if you want to prophylax migraine headaches....just start training for the Olympics DAILY! :)

I hope this addresses your concerns and that you'll keep me in mind for future questions regarding these or other neurological/medical issues. Feel free to upload images if you'd like.

Otherwise, I'd appreciate your rating this interaction with a HIGH STAR SCORE and look forward to a few words of feedback. In addition, I'd appreciate your CLOSING THIS QUERY if you're satisfied with my response.

Write to me any time at: bit.ly/drdariushsaghafi for additional comments, concerns, or to provide status updates if you'd like which I would love to receive from you to see just what has been discovered.

Many thanks for using this service to ask your questions. Be well.

This consult request has taken a total of 84 minutes of time to read, research, and respond.


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Dariush Saghafi

Neurologist

Practicing since :1988

Answered : 2473 Questions

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What causes headache and visual aura while climbing the stairs?

Brief Answer: Interesting type of problem Detailed Answer: Good evening. This is an interesting problem to try and figure out since intuitively one might guess just the opposite might be the case. In other words by RUNNING up the stairs one would increase heart rate, increase blood pressure, release more adrenalin, in general there would be an increase in metabolic activity which seems to be consistent with increasing stress and this automatically seems to be consistent with generation of a migraine type of headache. But in reality, just the opposite tends to happen. By increasing metabolic activity levels and kicking the baseline physiology into a higher gear there tends to be an interference pattern set up against overindulgence of the trigeminal nerve. This likely occurs by way of increasing brain levels and secretion of SEROTONIN which is a neurotransmitter that is known to act on receptors within brain structures that can SHORT CIRCUIT migraine headaches. This is the theory behind the idea of recommending more and higher levels of aerobic exercise to migraineurs. When simply WALKING up stairs there is not nearly the same level of increase in metabolic and physiologic activity and in fact, by climbing stairs more slowly one could be facilitating the onset of migraines by increasing fatigue over the time period it takes to climb (not run) the staircase. When fatigue increases, velocity up the stairs slows down and this in turn can affect blood pressure causing it to drop dramatically in a way that may induce a rapid heart rate, lightheadedness, flushing sensations, and MIGRAINE HEADACHES (usually with aura). The dropping blood pressure is known as ORTHOSTASIS. A positive correlation between the development of dropping blood pressure while a person is engaged in exercise activity or standing erect for a length of time (ORTHOSTASIS) and migraine headaches is known to exist. Therefore, when you climb stairs slowly you are facilitating the chain of events necessary to trigger the trigeminal nerve into action. Bottom line--- DO NOT CLIMB STAIRS slowly....and if you don't feel like jogging up the stairs then, TAKE THE ELEVATOR! LOL! And if you want to prophylax migraine headaches....just start training for the Olympics DAILY! :) I hope this addresses your concerns and that you'll keep me in mind for future questions regarding these or other neurological/medical issues. Feel free to upload images if you'd like. Otherwise, I'd appreciate your rating this interaction with a HIGH STAR SCORE and look forward to a few words of feedback. In addition, I'd appreciate your CLOSING THIS QUERY if you're satisfied with my response. Write to me any time at: bit.ly/drdariushsaghafi for additional comments, concerns, or to provide status updates if you'd like which I would love to receive from you to see just what has been discovered. Many thanks for using this service to ask your questions. Be well. This consult request has taken a total of 84 minutes of time to read, research, and respond.