The Clinton Herald, Clinton, Iowa

January 7, 2014

Migraine with vision loss scary, but can be treated

By Dr. Keith Roach
The Clinton Herald

---- — DEAR DR. ROACH: I am 64, and for many years have had migraine headaches with aura. One day, it turned very different. My sight was gone, sometimes in one eye, sometimes in both. This was new to me. I was told that it was retinal migraine, and my doctor said there was nothing he could do.

Please give me a little hope that something can be done. I am now afraid to drive. — E.J.A.

ANSWER: Migraine headaches are episodes of severe headaches, usually associated with nausea, light and sound sensitivity. It tends to run in families, and women are affected more often than men. An “aura” is a neurologic condition sometimes associated with migraine, especially visual disturbances (such as flickering lights or wavy lines) and loss of vision, especially peripheral vision. A reversible change in speech can be a form of aura as well.

Auras can be indistinguishable from a stroke or TIA, and the first time one experiences an aura, or a change in aura, the feeling can be terrifying. Sudden loss of vision should prompt an emergency visit as rapidly as possible, as an early stroke can be treated. In your case, you now know that vision loss can be the aura of a migraine.

Migraine with aura can indeed be treated. Treatment can be to stop an attack, or to prevent one. Many migraine specialists recommend preventive treatment for someone with ocular or retinal migraine. There are many, many kinds of treatments, ranging from prescription medications to vitamins (especially riboflavin, vitamin B-2) and supplements such as magnesium. See your doctor again, and ask him about treatments for prevention.

DEAR DR. ROACH: I am a 77-year-old woman in good health. Recently, I donated blood for the first time in 20 years. Since then, the American Red Cross has contacted me several times to donate platelets because I have so many of them in my blood.

My question is, Since so many of my relatives have died of heart problems, could having a lot of platelets increase my chances of blood clots that could lead to stroke or heart attack? — P.N.

ANSWER: First off, I would have to know if your platelet count is normal or abnormal. With normal platelet count, you can donate platelets very frequently — the American Red Cross says up to 24 times per year. Platelets are removed from the blood during donation, and you keep the rest of the blood components.

Abnormally high platelet counts can be caused by many conditions, but persistently high levels should raise the possibility of the condition essential thrombocythemia, also called essential thrombocytosis. (”Essential” in this case doesn’t mean “necessary,” it means “unexplained.” “Thrombo” is from the Greek word for “clot,” and “cyte” means “cell.”) Both excess bleeding and excess clotting occasionally occur with ET.

Although most cases of ET have no effect on lifespan, the condition can develop into leukemia or other related diseases, and a visit to a hematologist — a blood specialist — is in order.