Is It An NMO Attack or Migraine?

In my experience in living with NMO and migraines, it has been challenging to differentiate the two. One of my very first symptoms back in 2013, 3 years before getting my diagnosis, I had an awful eye pain accompanied with pain followed by an intense headache. NMO alone in my case was highly disabling, with symptoms such as blurred vision, muscle weakness, nausea, and severe fatigue.

Combining NMO with the intense pain and neurological disturbance of migraines significantly impairs my ability to function (and frankly it sucks).

What are migraines like?

Having a migraine for me leads to debilitating chronic pain and being less present in daily activities. For someone like me, who is a mother of two active boys, this can be stressful. I often feel guilty for not being present at that moment. I often get feelings of frustration and anxiety because I never know if what I'm about to experiencing is going to be a NMO attack or migraine.

It took me sometime to recognize the symptoms of a migraine. For example, two days before the migraine I would get what is called the aura. I would see flashes of lights in my vision, almost like silent fireworks in my level of vision. I would also get random feeling of pain on different parts of my head. It felt like I was being randomly punched in my head.

The worst is thirst, the thirst feels like a bottomless sink hole that will never fill up. Then I get tingling and numbness in my hands and fingers, a sense of heaviness and weakness throughout my body, accompanied with brain fog. It is usually hard for me to be transferred because of my heaviness, and when someone helps I feel like a dead body.

Consulting my neurologist

When I reached out to my neurologist, they never knew if I was experiencing a pseudo-flare, an infection, a migraine or a real flare because of a new lesion, so I was always recommended to go to the emergency room. But when I started recognizing my migraine symptoms, I went less to the ER, and was able to take care of my migraines at home.

It took some to figure out, but with the correct team of neurologists we were able to come up with a plan of prevention and plan of action.

Plan of action

My migraines were lasting up to six weeks at a time and it was horrible. Not every day was “bad”; somedays my head wouldn’t pound, but the effects on my body were very debilitating.

Trying Botox

I went on to try Botox on my shoulder traps, neck and head. I thought free Botox on my forehead, who wouldn’t right? Wrong! I got Botox everywhere but my forehead because after my first experience it changed my facial expression, and it looked like I had 2 horns implanted under my skin.

Trying Nurtec

I also took dissolvable pills under my tongue called Nurtec and that was a true change gamer for me. For me, Nurtec instantly took the migraine head pain away and I was at least able to function. A bit slower than usual, but it worked.

Hydration
Staying hydrated is a big one when dealing with my migraines. I would often drink water, coconut water and Gatorade.

Anti-nausea

I would keep anti-nausea medication on hand because I would experience severe nausea. I also found that chalky candy like Sweet Tarts or super sour gummies would also help calm my nausea. Or maybe it was my way of comforting myself during those terrible days. The cravings were intense after the nausea calmed down.

Learning the difference between migraines and flares

It took time to learn the difference between migraines and NMO flares. Thankfully with the help of my team of neurologists, we were able to figure out ways to combat the issue. Now I get Botox injections every 3 months. I have medicine on hand including Nurtec and anti-nausea medication. My stash of candy is hidden because if my kids find it, it will be gone in 2 minutes. And I just take things really easy those days. No big decision making, no major meetings, just resting comfortably.