Diving migraine

[garak112]

I'm thinking of booking my next trip and wanted to understand what had happened on my last few dives before committing to anything.

I get migraines once a month or so but have never had one whilst diving, although I've only logged 30 dives.

I was doing a deep diving course and the dive profile was one dive to 40m down a rope, perform some simple tasks and then watching the local sealife whilst swimming gently back to the boat. The total time was 37 minutes. Dive two was down to 40m then back up to explore some wrecks, total time 46 minutes. Both dives on 28% nitrox.

On dive one as I finished the simple tasks at the bottom I started to get a really intense migraine. I signalled to my buddy and we moved up to about 25m and it went away. I thought one of my sinuses had been blocked or something and it had cleared. Towards the end of the dive at a shallow depth it came back until we surfaced. I discussed it with my dive instructor who thought I might have been dehydrated and told me to drink water.

An hour later I felt fine and assumed it was the water issue and began dive 2. All was well until the last third of the dive when the migraine returned with a vengeance at about 20m. It went after about 5 minutes being out of the water.

A few hours after the dive I noticed blurry vision in one eye (which I sometimes get with migraines) and this came and went for a few hours with no migraine.

Did a shallow dive to 18m a few days later for an hour and had no issues but the the blurry migraine eye returned and lasted a week. GP and optician couldn't find anything wrong.

Any ideas?

 

[Angelo Farina]

A number of my former students did experience migraines when breathing improperly due to CO2 accumulation.
Learning to breath properly, discharging efficiently the CO2 you are producing, usually solves the issue.
Problem is that training to proper breathing control almost disappeared in scuba training, after we switched from using CC pure oxygen rebreathers to normal air tanks in open circuit.
Currently most instructors simply say to their students to "breath normally", which of course is not what you should do for being sure of not accumulating too much CO2.
Some guidance to correct breathing control is provided in many sites, for example here: Dive Training: Save Your Breath

 

[scubaozy]

I generally agree with above comment; it is possible to accumulate CO2 event one thinks their breathing is normal. But I find it disconcerting if you did two deep dives and have blurry vision short afterwards. Changes in hearing or vision post dive may relate to dci.

 

[Duke Dive Medicine]

I'm thinking of booking my next trip and wanted to understand what had happened on my last few dives before committing to anything.

I get migraines once a month or so but have never had one whilst diving, although I've only logged 30 dives.

I was doing a deep diving course and the dive profile was one dive to 40m down a rope, perform some simple tasks and then watching the local sealife whilst swimming gently back to the boat. The total time was 37 minutes. Dive two was down to 40m then back up to explore some wrecks, total time 46 minutes. Both dives on 28% nitrox.

On dive one as I finished the simple tasks at the bottom I started to get a really intense migraine. I signalled to my buddy and we moved up to about 25m and it went away. I thought one of my sinuses had been blocked or something and it had cleared. Towards the end of the dive at a shallow depth it came back until we surfaced. I discussed it with my dive instructor who thought I might have been dehydrated and told me to drink water.

An hour later I felt fine and assumed it was the water issue and began dive 2. All was well until the last third of the dive when the migraine returned with a vengeance at about 20m. It went after about 5 minutes being out of the water.

A few hours after the dive I noticed blurry vision in one eye (which I sometimes get with migraines) and this came and went for a few hours with no migraine.

Did a shallow dive to 18m a few days later for an hour and had no issues but the the blurry migraine eye returned and lasted a week. GP and optician couldn't find anything wrong.

Any ideas?

Concur with @Angelo Farina in that it's possible that you had CO2 toxicity, though the spontaneous resolution on ascent from 40 m to 25 m makes me wonder if it wasn't a sinus barotrauma as you suggested. There are case reports in the literature of sinus barotrauma causing vision changes in divers and mountaineers with a bony dehiscence in the sphenoid sinus, which exposes the optic nerve to pressure changes inside the sinus. Of course that's not a diagnosis, but it's something to explore with an ENT physician. I think that decompression illness is pretty low on the differential since your symptoms occurred at depth.

Best regards,
DDM