I am experiencing headaches due to light sensitivity. Why?

Question

Hi doctor,

I am a 20 year old female. For the past three months, I have been experiencing daily headaches, intermittent dizziness and vertigo, tinnitus and light sensitivity. I have received a diagnosis of a vestibular migraine and my neurologist reports down beating nystagmus while using Frenzel goggles and performing the Dix-Hallpike maneuver. My magnetic resonance imaging (MRI) is clear aside from sinusitis and all vestibular testing came back normal. I have just picked up on a very significant symptom that my neurologist is not aware of. In certain lights like fluorescent lights, if I close my eyes about 10-15 seconds, then my eyes begin jerking uncontrollably and my eyelids flutter or open and close uncontrollably. My eyes also move upwards and into my head during this. This lasts for about 10 seconds at a time, whereby it will calm down and start again at some point if my eyes remain closed. This does not happen when I am in a dark room (such as when going to sleep). I had never experienced this before the above symptoms started. I am wondering if this is a form of nystagmus or some seizure.

Answer 1

Hi,

Welcome to icliniq.com. We are here to help you. Your symptoms are suggestive of a migraine only. The new symptom that you have noticed also is in favor of a migraine headache. In such case, I would recommend you not to worry as all your investigations are within normal limits. Migraine headaches are precipitated by light, sounds, sleep deprivation, illness and medicines. Once we are sure that the person has a migraine, we start our patient on migraine prophylaxis. If you are on migraine prophylaxis, slowly your severity and frequency of attacks would reduce and time will come, when you will have almost no attacks. Drugs are decided based on the frequency and the severity of the headache. Sleep disturbances are also kept in consideration. For migraine prophylaxis, the most commonly used drugs like Flunarizine, Propranolol and Amitriptyline. In the case of acute pain, triptans like Sumatriptan and Rizatriptan are used. In the case of acute pain not responding to triptans, we use painkiller NSAIDs (nonsteroidal anti-inflammatory drugs) like Diclofenac. You also need to modify your lifestyle. You should sleep at least 8 hours at night, that too daily in a fixed time slot. Avoid sleeping in the day time. If you sleep in the day, you will have difficulty in falling asleep on time in the night and the whole cycle of peaceful sleep would get disturbed. Avoid alcohol, beer, caffeine, lemon and cheese in the diet. You need to follow these lifestyle modifications for the purpose of getting rid of medications after a few months course. People who modify their lifestyles usually get rid of medications after six months course.