So why do you need a service dog anyway?: A bit about Acephalgic migraine


Migraine awareness month is June, but I figured I’d get things rolling and talk about my chronic migraine condition.

A few months ago I finally got a straight-up diagnosis for my neurological problems. I want to take this opportunity to say a few words about Acephalgic migraine or “Silent Migraine”.


When the average person pictures a migraine, the first thing that comes to mind is pain. It actually is true in most cases. Migraines can be incredibly painful and disabling. What many people don’t know is that migraines come with a variety of other symptoms besides the head pain. Every time a person has a migraine, they typically go through 4 stages:

  1. Prodrone: Prodrone is the migraine’s overture. It is a variety of symptoms that warn that a migraine is coming. A person in the prodrone stage of a migraine will feel irritable and/or confused, will throw up or have diarrhea or both, and they’ll start to become light-sensitive.
  2. Aura: Aura can happen before a person feels the head-pain or while the pain is happening. Aura can actually be quite intense and debilitating. A person will start to exhibit neurological symptoms such as speech disturbances, problems walking or navigating, and increased sensitivity to light and sound. The person may fall, they may feel numbness or weakness in their arms and legs, and they may reach an increased state of confusion. Perhaps, the most notable characteristic of the aura state are visual symptoms. A person suffering aura may have blurred vision, tunnel vision, or may see spots of light.
  3. Pain: Migraine sufferers typically experience debilitating pain. The pain is usually centered on one side of the head and it’s a throbbing/stabbing type of pain. A single migraine can cause up to 72 hours of excruciating pain, often necessitating hospitalization.
  4. Resolution: After the pain subsides, migraine sufferers often feel exhausted, fatigued, and weak. This feeling of severe exhaustion can last up to 24 hours.

People like me, who suffer from chronic Acephalgic migraine, have all the above symptoms except for the head pain. This makes the condition notoriously difficult to diagnose. Before I was diagnosed with my migraines, I had to be checked for brain tumors, brain damage, multiple sclerosis, lyme disease, and I even had to go through therapy for somatoform disorder (hypochondria). It wasn’t until I had ruled all these things out that a headache specialist was able to diagnose me with silent migraine.

Except, in my case, pain's invitation got lost in the mail.

Except, in my case, pain’s invitation got lost in the mail.

My migraines are triggered by florescent lights. I’ve always had them, to some extent, but they became debilitating in 2010 after I was diagnosed with a cornea disorder called Keratoconus. Keratoconus occurs when the cornea becomes misshapen, growing into a “cone-like” shape. Because the cornea is no longer spherical, it does not refract as much light as a healthy cornea, letting more light into the eye. I was able to wear special contacts for my eye problem for awhile, but eventually my chronic dry eye made it impossible to continue the special contacts. I now wear glasses, which don’t fix much. I still have double (or triple, or quadruple) vision and I can’t read large blocks of text.

A normal cornea (left) and a cornea with Keratoconus (right).

A normal cornea (left) and a cornea with Keratoconus (right).

Since Keratoconus can cause blindness, I also had to have a procedure done called “corneal cross-linking”. While the procedure itself is non-invasive and safe, the doctor had to scrape a small layer of epidermis off my cornea. I was blind and in terrible pain for about 3 weeks after that. The procedure didn’t fix the problem, it just stopped it from progressing. My corneas will always be misshapen.

I can run, play, swim, etc. outside without a service dog (although I do take Daphne on outdoor outings because once in awhile my migraines get triggered by things besides florescent lights). However, as soon as I go under florescent lights, I begin to vomit, I become extremely confused, and I start to have problems processing what I see and navigating. I also become unsteady on my feet and can fall. Daphne is trained to help me walk, to guide me around corners, and to pick up things when I drop them. She can also find a few specific people (Stefan and my mom) in a large indoor space if I get separated from them.

Not many people have service dogs for migraines, but most people can’t function at all when they’re in pain from migraines, let alone work interactively with an animal. Also, most people don’t know that in the US, service dogs can legally be used for almost any disability. Any medical problem that limits one or more of your daily life activities (walking, thinking, moving, seeing, hearing, etc.) is legally a disability for purposes of using a service dog. The dog must be trained in at least one task that mitigates the disability.

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In addition to the incredibly disabling features of my migraines, they also put me at risk for a few health concerns. Perhaps the largest health risk for a person suffering from Acephalgic migraine is the likelihood that that person will develop head pain associated with the migraine. Also, anyone who has the “aura” stage of their migraines is at a significant risk for stroke. A study conducted with 100,000 women under 35 suggested that women who have migraine with aura are 6 times as likely to have a stroke than women who didn’t .

I also take the birth control pill. I absolutely need to stay on it because it helps control a lot of other dangerous medical problems that I am currently suffering from. Women on the pill who suffer from migraine with aura are 25 times as likely (about 28 in 100,000) to have a stroke than women who don’t take the pill or have aura.

I am also a smoker. This increases my risk of stroke about 4 times (about 100 in 100,000). I do think I will eventually quit, though. I do not expect to be a life-long smoker.

The use of a service dog for my migraines gives me incredible independence. I would recommend a service dog to anyone suffering the debilitating affects of Acephalgic migraine.


One thought on “So why do you need a service dog anyway?: A bit about Acephalgic migraine

  1. Hi, I just came across this page via a Google search and I would love to talk to you! Like you, I have chronic silent migraines that are triggered by fluorescent lights (as well as sunlight). I also have a service dog who helps me with mobility work and other tasks for my migraines and other disabilities. I’m in the process of getting my successor dog, as well, as my current service dog is almost finished with a round of chemo for cancer. If you wish to get in touch with me, send me an e-mail via my dog’s Web site. 🙂

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