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Are Ocular Migraines (scintillating scotoma) really seizures?

In the past week I've had 2 experiences that I'm told are scintillating scotoma or ocular migraines.. I was diagnosed over the phone by my opthamologists nurse (which really makes me crazy!!) Havent spoken to my Neurologist yet as it was the weekend..  I got finished exercising started to feel a little funny, looked down and there was a partial blind spot,darkness where there should have been my dog.. I looked to the left side and started to see a squiggly line moving up and down..this scared the heck out of me.. I went clear across my house to go sit down (go figure?)  all the time the lines kept moving.. Sat down.. I closed my eyes,continued to see the squiggles it petrified me but I was also determined to get to my computer to look this nightmare up.. got up & was incredibly dizzy and dont remember walking to my computer. this lasted maybe 5 minutes more & probably in total 10-15 minutes (i think?) then went away with a slight headache starting on the opposite side.

 The 2nd time was a little different and shorter. I left my house to go get my prescription, it was really sunny out & I didnt have sun glasses on right away.. ( i'm thinking photo sensitivity trigger) got to the drug store,went inside took my sunglasses off and started having that same experience with blind spots but this time on the right side.. my pharmacist,thank goodness, is a Dr and told me this is happening from Keppra xr and if it got unmanagable to change meds! My seizures are finally under control with the Keppra XR for the last month and now this... I cant imagine changing meds again!! After this happened the 2nd time I just went on with my errands for another 10 minutes and then home.. Was I really having a simple partial seizure? For sure my judgement was off both times .. Anybody have a similar experience or have any knowledge of this?

I do plan on calling my Dr in the morning.. MRI anyone? (:



Hi Sash07,

I have had symptoms of migraines and symptoms of temporal lobe epilepsy long before taking any AEDs; once
I told an ER doctor that I was having mild seizures and she told me I had a migraine; another time,
I told an ER doctor that I just had a severe migraine and he told me I had a seizure. It is very
confusing also for doctors, but when my partial seizures started to spread into secondary tonic-clonics
frequently, the greater weight of my symptoms went to a case of epilepsy instead of just migraines.

Many Anti-epileptic medications are also beneficial with migraines, while many migraine medicines
will lower a person's seizure threshold and aggravate epileptic conditions. Occipital lobe epilepsies
are often confounded with "only" migraines, when in fact it is a "occipital seizure-migraine" sequence.
While migraine syndromes are much much more common than epileptic syndromes, carefull doctors should be
on the lookout for both possibilities with migraine symptoms, and many neurologist address the
dividing line between ambiguous similiarities of migraine versus epilepsy with the term "migralepsy,"
in cases where migraine aura tend to induce partial seizures. A crude rule-of-thumb is if the migraine aura
is less than five minutes, suspect epilepsy; if the migraine aura is longer than five minutes, consider
it only migraine.

For me, sometimes a severe headache precedes a "migraine without pain" where my face/head becomes
numb and the pain vanishes, and other times numbness will become a severe headache with various
symptoms of ocular to general migraines. Two AEDs I had been regularly taking, Dilantin and Keppra, reduced
the secondary tonic-clonics, but didn't do much at all with partials and migraines. Now I only take
Keppra around warning periods of tonic-clonics, and the intermittent Keppra helps me to sleep through
many migraines, while regular usage of Keppra seemed to preclude this benefit. All professional
medical sources advises to only take Keppra as prescribed, but I'm on Medicaid in California and the
State Budget/Funded Doctors takes precedence over prescription instructions; so my intermittent
Keppra isn't by the general advice, and it works at preventing tonic-clonics about 3/4 the time with
warning, while hopefully moderating a total cessation of Keppra when I run out of Keppra if the
Budget/Medical doctor mess is not resolved by then. Dilantin was an osteoporosis problem for me, but
neither Dilantin nor Keppra seemed to increase any of my migraine problems as to my present memory.

Also, a few years ago I tried to wait out a very long migraine after a secondary tonic-clonic, but
it turned out to be a life threatening subdural hematoma that required emergency surgery when it
started to alternate between periods of extreme pain/blindness and total body numbness.

I hope this helps.

Hi 3hours 

Thanks for your reply.  From what I've been reading, it seems the ocular migraine/seizure syndrome is predictable but that the aura could be from so many different things as well. Online I found nothing connecting OM to Keppra XR and yet my pharmacist was so positive it was the culprit. From your experience it seems I better check out all avenues or I could find myself in trouble.. So with that, I have an appointment with my Opthamoligist Friday and to get blood work done & I'll take it from there.. that gives me this week to see if I get any more auras. So far its only happened those 2 times & once 8 months ago. So glad I keep a journal!

I also took Dilantin and ended up with Osteoporosis and had minimal seizure control for simple partials. Keppra taken intermitently didnt work for me at all. You are lucky.

Hopefully the budget/Dr problems will work out in your favor. Does anybody that doesnt have E realize what an impossible puzzle this is to us at times? We should all be able to have access to the meds we need that work for us because so few do. The cost of the newer drugs is mind boggling and so unfair. I believe we with E need bailout $

My Best to you


Attitude is everything. Be kinder than necessary, for everyone you meet is fighting some kind of battle. Live simply, Love generously, Care deeply, Speak kindly.......

 Thanks for some very useful information. I must ask my doctor about me trying Anti-epileptic medications to see if I can get some relief for my migraines from them. I am currently trialing a blood pressure tablet but it anly seems to work infrquently.

  You might like to look at my migraine site at:-

    Regards to all migraine sufferers 

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