Light-induced migraine is common, and light often amplifies the pain after the headache has begun, Dr. David Dodick of the Mayo Clinic explains in response to reader questions on the Consults blog.
Fluorescent Lighting, Computer Monitors and Migraines
Q.
My husband gets disabling headaches from fluorescent lighting, even the new compact ones that look more like incandescent light. Also from looking directly at LCD monitors. Although he works at home and can avoid this lighting for the most part, it’s very disabling, prevents him from going many places that he’d like to, taking our daughter places, etc.
Once he’s affected, the only thing that really helps is sleeping. He’s being treated by a neurologist (who has diagnosed them as migraine), but the one med that seemed to help (I think Topamax) left him with exhaustion as a side effect, so he had to stop taking it. Wearing a baseball cap and sunglasses helps him tolerate the lighting a little better, but not much. The effects are much, much worse earlier in the day; he can tolerate greater exposure if it’s later in the day. Is there anything in the research literature about light-induced migraine and treatment strategies?
Ellen, New England
Ellen, New England
A.
Dr. Dodick responds:
Light-induced migraine is common, and light often amplifies the pain after the headache has begun. (Doctors refer to this occurrence as photophobia.) There is exciting new research on the anatomical pathways that account for how and why migraine is worsened by light, and ongoing research to explain how and why light may trigger a migraine attack.
There aren’t novel treatment strategies yet to deal with light as a trigger, other than what your husband has already tried. That includes the use of preventive medications like topiramate (brand name Topamax), which may reduce one’s susceptibility to light as a trigger, so long as he and his physician can find a drug that he tolerates. I am confident that as we learn more about the mechanism involved in light as a trigger over the next five years, we will find better strategies to circumvent this problem.
Loss of Focus and Sensitivity to Light and Sound
Q.
I often get headaches that are only moderately painful but are debilitating — I can’t think clearly or focus, am sensitive to light and sound, lack normal appetite, am lethargic. Could this be some kind of migraine?
Anonymous, San Francisco
Anonymous, San Francisco
A.
Dr. Dodick responds:
Indeed, the cognitive symptoms, sensitivity to light and sound, lack of appetite and lethargy are very typical symptoms of migraine. However, other disorders can mimic the symptoms of migraine. A thorough evaluation by your physician is necessary to arrive at an accurate diagnosis so that you can receive appropriate treatment.
For more on migraine, see Dr. Dodick’s responses in the Related Posts section, below, and The Times Health Guide: Migraine.
