Migraine and prednisolone

[Smithie49]

Does anyone else suffer with migraines while taking prednisolone which I take for PMR (7.5 mg at present)? I started having migraine with aura several months ago and they seem to be getting more frequent. There's no pain, just this unpleasant visual disturbance. I've had my eyes tested and they're fine. There doesn't seem to be any particular food that triggers them.

[SnazzyD]

Sorry, a few questions have sprung to mind. Why was it diagnosed as migraine? what kind of visual disturbance and how often and for how long? Any particular time of day or activity associated with it?

What kind of eye test was done and by whom?

[Smithie49 in reply to SnazzyD]

Hi Snazzy. I've not had an official diagnosis but it started a few months back when I would lose a letter here and there and to read the full word would have to turn my head to move the blind spot. Sometime after that I'd get star shaped images and now that flashes and jiggles about. I get a slight pressure (difficult to describe) around my eyes and a slight discomfort in my oesophagus and throat. They occur randomly and don't seem to be associated with any food or activity.

I had a full eye test in my opticians and mentioned the migraines but she wasn't concerned.

[SnazzyD in reply to Smithie49]

Personally I wouldn’t want to just explain that suite of symptoms as migraine on the basis that the optician can’t see a problem. The increasing visual disturbance pressure and the throat sensations could be caused by other things including GCA or larger vessel inflammation.

[PMRpro Ambassador in reply to Smithie49]

And I agree with Snazzy. Too many leaps of faith there for me,

[Sillydogsmum in reply to Smithie49]

Isnt obviously migraine at all really. Best get it looked into IMO.

[Sophiestree in reply to Smithie49]

When you saw the optician did you let them know you have PMR? Migraine aura doesn't last a very long time. The fact you felt pressure in your eye and discomfort in your throat needs double checking for GCA/LVV. I had those exact symptoms.I started to get them about 6 months before I got ill. Have always been prone to migraine but never this experience.But mine stopped all vision until it passed. The fact you could see but had to turn your head feels different to me.

[PMRpro Ambassador]

Possible I suppose - but pred is also sometimes used in the management of migraine. Has it been diagnosed by a specialist?

This article is a warning against too many assumptions:

ncbi.nlm.nih.gov/pmc/articl...

and the fact your headaches coincided with PMR and have worsened with reducing pred dose would suggest that it might not be as simple as your doctor seems to think.

[Smithie49 in reply to PMRpro]

Hi PMRPro. Thanks for your reply. I've not mentioned it to any medical person as it doesn’t seem serious but it is unpleasant .

[PMRpro Ambassador in reply to Smithie49]

I do think you need to - fair enough when a medical professional says it is migraine but it COULD be something else and should be looked at.

[Telian in reply to PMRpro]

I agree. I was treat for migraines even though I told them these are not the migraine headaches I used to get. I was sent to TIA and Maxofillia clinics who all said migraines! When my sight deteriorated badly in one eye and the headache from hell never improved my GP fast tracked me to Fheumatology where Prof D carried out an ultrasound and diagnosed GCA. Put me on 50mg Pred and within 6-8 hours I felt like a new woman. I’m extremely grateful for my fast acting GP. Not getting checked out isn’t a risk to take. I also had a TAB 4 days after the ultrasound which was negative. No surprise as already on Pred.

[PMRpro Ambassador in reply to Telian]

So even if a medical professional says it isn't - nothing beats that one extra test. The ultrasound is so useful.

[Telian in reply to PMRpro]

Agree entirely

[DorsetLady PMRGCAuk volunteer in reply to Smithie49]

Don’t think you should take that approach - it may not seem serious - but that’s not a guarantee it isn’t.

It does need medical input -if only to rule out anything serious.. fully agree with others.

Better safe than sorry …

[Sillydogsmum]

I have migraine with visual aura, flashing crescents etc. I have just recently realised that the feeling I get when I decrease my Pred by 1.25mgs or more in one go is exactly the same as the post dromal symptoms I suffer after the migraine ie off balance, vague headche, thinking difficulties etc. This time I have just dropped by 0.5mgs every 4 days from 16.26 to 15mgs without these symptoms. So maybe migraine has some link to the Pred. However if you are a first time migraine sufferer of a 'certain age' I would discuss it with your Dr jto confirm the diagnosis , exclude other possibilties etc. Migraine with aura has a minor but definite association with increased stroke risk in our age group.

[prunus]

I have been a migraine with aura sufferer since I was nine years old. I have had three relapses from my GCA and the third and most recent started with fifty such attacks within twenty three days. It was very upsetting at the time. I was referred to a neurologist but was not explained. Thank goodness I've come out of that. Your experience sounds not dissimilar to mine. The best of luck to you.

[Smithie49 in reply to prunus]

That sounds horrible. I'm glad your through to a better side!! Long may it last.

[Blearyeyed]

My migraine with aura got worse both before developing uvietis and GCA. It was actually found by my opthalmology consultant on a follow up appointment.Your optician may not have either had the experience or equipment to spot this especially if you didn't mention you already have PMR.

I think a call to the local Emergency Eye Clinic would be a good option especially as you also mention some jaw symptoms. Explain your history and concern about GCA.

Also speak to the GP.

My Migraines were only worse on much higher doses under 10mg they lessened. It's definitely worth a second opinion because even if the Migraines aren't linked to your PMR you could get a preventative medication to stop them.

Increasing Migraines never have no other underlying physical cause from my experience.

Let us know how you get on. Take care, Bee

[Hev77]

hi there - definitely a good idea to double check everything that's going on.

Interestingly since I've been on Pred I never had one migraine, despite having quite regular migraines beforehand. They were without aura though but fairly severe. So Pred for me, has been great regards keeping the migraines at bay.

I did however have episodes of Scintillating Scotoma (with no headaches) just prior to GCA diagnosis, apparently a very small percentage of GCA sufferers get these. The Pred also kept those at bay until I got down to 8mgs, at which time I started to get an occasional one here and there. Perhaps you could be experiencing something like that? X

[Smithie49 in reply to Hev77]

Many thanks. Hev77. I'll look that up as I've never hear of it.

[Kiwisufferer2019]

Yes, I get migraines, but with pain, particularly bad when I'm trying to taper. Just had temporal scan on Tuesday in case GCA, but arteries all good, and eye. I wrote a long post 10 days ago, and lost it when trying to post. Rheumy I saw on tuesday said he's 99.9% sure it's the migraine, but this time I've had it for 2 weeks and very little relief from rizatlipan which usually knocks it on the head pretty quick. He's upped my dose of amitriptyline as a preventative, which I was taking for post zoster neuralgia, shingles pain. It's a real pain, only up side is because I haven't been feeling great, haven't been feeling like eating, and have lost 4 kg last 10 days. It's a journey and a half that's for sure. Back to my normal Rheumy tuesday morning. In the meantime cuttingback from 20mg pred to 15, then 10. A colleague of his fitted me in for the scan. For the first time in several months my neck pain znd hip pain has gone in the past 2 weeks on the 20mg pred. Good luck to you . Janis

[PMRpro Ambassador in reply to Kiwisufferer2019]

"For the first time in several months my neck pain znd hip pain has gone in the past 2 weeks on the 20mg pred"

Which in itself raises some questions ...

[Kiwisufferer2019 in reply to PMRpro]

Yes PMR PRO, I'll be asking some questions about that come Tuesday! Seems 10mg was too low.

[PMRpro Ambassador in reply to Kiwisufferer2019]

I'd say so ...

[Kiwisufferer2019 in reply to PMRpro]

I'm going to try and print the article you posted on normal markers and pmr symptoms, although my ferritin is high.

[PMRpro Ambassador in reply to Kiwisufferer2019]

Which may be YOUR marker - it was mine but they don't usually check it.

[yogabonnie]

I have migraines with auras. I found that if I consistently take magnesium which I should anyway with D3 vit. they are much fewer and farther between

[Smithie49 in reply to yogabonnie]

Many thanks. What form is the Mg you take? It is in the multivits that I take on and off but maybe not enough eh?

[yogabonnie]

It is separate pill from multivits. just magnesium. not sure of the amt. as I am not home until next week and didnt bring them. but I take a multi vit plus magnesium.