16 year old sudden partial loss of vision - advice

[thunderbee]

My 16 year old son has had second episode in right eye of a whole chunk of the visual field going dark, basically a kind of partial blindness. Last time it happened it was 6 months ago, he refused to go to A&E and it disappeared over about half an hour.
This afternoon it happened quite suddenly after he got out of the shower, and was accompanied by a left side headache which came on after and is hanging around, worse when bending down or exerting himself; and also at the time of the visual disturbance, pins and needles/numbness down into his right hand and in his face under his eye. He was very slightly struggling to find the right words for things for a few minutes too.
We've just spent 3 hours at A&E where the consultant tells us it's likely to be a migraine. Am I being ridiculous to think this just doesn't seem quite right as a conclusion? No history of migraines or seizures or anything else relevant.
Should we just wait till the next episode? Son is very freaked out, as am I. He is usually well, very fit and sporty gym type.
Any advice really gratefully received.

I get migraines like that. In fact my normal first symptom is losing a chunk of my vision - normally peripheral - and then I get the headache. Of course it could be something more serious but it never has been for me.

I’ve no medical knowledge. But was coming on to say migraine. I’ve experience of someone I know having the vision loss

Yeah my DD got migraines with loss of vision at about the same age.

I occasionally lose my peripheral vision in one eye and/or have a blind spot which is accompanied by flashing lights. Normally lasts about half an hour. It happened for the first time when I was driving and part of the number plate of the car in front was blanked out.

I've mentioned it at my last two eye tests and the optician said it was an 'optical migraine' and as long as it goes on it's own quite quickly he wasn't too concerned. I've kept a record of all the ones I've had since Christmas so when I next get my eyes tested I can show him the evidence of frequency and exact symptoms.

My DH had exactly this for the first time a couple of years ago, loss of vision followed by headache and difficulty finding words. He had an MRI and went to the stroke clinic but everything showed it was just a migraine. He gets them now if he's very stressed and sleep deprived.

Just to add, I've never had a headache or pins & needles with it. Purely visual disturbances.

Did they do an mri or any examinations? Is there any follow up? I think you need a second opinion. It could very well be a migraine but I would email your gp tomorrow and ask for an appointment to discuss and get a referral on. All the best.

What you have described is a classic migraine , mine started out of the blue when I was 14 and have continued ever since - I’m now 37 😭

I had this a few years ago. It was like a grey shutter coming halfway down one eye. It stayed a few mins and then slowly drifted off to the side over about 10mins. Was seen by the eye clinic at the hospital - nothing to do with migraines, it was an interruption to the blood supply to the eye, like a sort of stroke they said. Had a few follow up appointments but it never happened again. Was told to go straight to hospital if it does though. I would def recommend getting this checked out ASAP

My migraines follow a similar pattern to your DS. I have had them since childhood, peaking during adolescence and again during pregnancy (clearly hormones play a large part in mine). They were so bad during my last pregnancy that I was hospitalised for 3 nights and had an MRI. Still the diagnosis was migraine.
Regular pattern: loss of vision/weird zigzaggy patterns across eyes obscuring vision, loss of speech, unable to write, pins & needles sensation tongue, arms, hands, followed by splitting headache, nausea &
vomiting, unable to cope with light or noise. It would take 2-3 days of utter exhaustion to recover. Migraines can be absolutely horrendous, I often truly believed I was going to die. A migraine is not just a bad headache, so I totally sympathise with your DS.

Might be a migraine. Might not. Push for neurology referral.

I had migraines with complete loss of vision and extreme abdominal pain. I thought it was period pain because it coincided with the beginning of my period. But nope menstrual migraine. Saw a neurologist got meds, fixed, resolved itself completely after pregnancy. I never had a headache.

Tbh I was flummoxed by it because there was absolutely no pain in my head, I was referred to neurologist by gynaecologist. It was really odd trying to accept that none of the extreme (and i mean sweating with pain, going to pass out and going blind) pain originated in the places I felt pain.

A relative of mine gets symptoms similar to a stroke when she gets a migraine (it def is not a stroke but a migraine, it’s been checked) She worries if she’ll ever get a stroke when she’s older she will ignore the symptoms 🥴 Migraines can take on some wierd symptoms

Sorry also I had a previous bout of migraine with aphasia (scariest thing ever, couldn’t use my hands couldn’t speak and couldn’t read) I had an MRI and it was a migraine with an aura.

Another one saying migraine this is exactly what mine are like and they started when I was 15. Scared the life out of me and I’ll be honest that partial loss of vision still scares me every time it happens even though I know what it is!

sounds like migraine to me too. I go totally blind for a while with mine, was terrifying when they started as a teenager! best to get it checked again regardless.

I meant to say still push for a second opinion as it’s worth it but it does sound like a migraine

Sounds like a migraine to me too. I get blind spots, numbness, pins and needles and the last time I had quite serious confusion with it - couldn't string sentences together for a while without concentrating very hard. Sometimes has a headache as well but I have been known to get those symptoms without the headache too.

Thanks all, this is really helpful, and I am so sorry to hear so many have such debilitating migraine symptoms. It really sounds horrendous for many.
I am thinking one thing I could do tomorrow for DS is try to get an emergency optician appointment so that they could at least look at the back of the eye (A&E this afternoon was crazy, and none of the electrics were working in the consultation room, so the consultant couldn't inspect the eye itself) and see if there was anything like pressure on it?
I am of course thinking the worst, as in stroke or tumour...so I guess we might be doing this more for me, since we can't really go to A&E again, and getting a GP appointment for something where we've already been to A&E seems unlikely

Almost certainly a migraine BUT they really should do an MRI to rule out brain tumors, stroke and other big nasties which have very similar symptoms. IMHO to diagnose migraine without imaging is very poor and you should push hard for a very fast referral to a neurologist…..like tomorrow. Some of the nasties need rapid treatment to ward off life long disabling consequences

It's worth having someone check his eye just in case, but I get migraines like this too.

Sounds like an ocular migraine. I've had a few myself although I get the visual disturbances without the headache

Thank you, sounds like I need also to go GP route then. A&E consultant said no point in CT scan as just exposing DS to radiation and very unlikely to be anything serious. Explained the pins and needles and spasm of blood vessels and that there would be ongoing deficits if stroke apparently. No mention of tumour as a consideration

as spasm of blood vessels, sorry

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