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28 Feb 2009

migraines and depersonalization
Since June 2008 I have been suffering from silent migraines with moderate pain, tingling, and burning behind and around the eyes. Occasionally I' ll see flashing lights and floaters, and experience some lightheadedness. I' ve also been suffering from depersonalization which has been constant (with varying degrees of intensity) since the beginning of the migraines. I also suffer from sleep paralysis (usually one episode a week). What' s strange is that when the migraine is gone, the depersonalization still remains. I haven' t been on any medication for these, I' ve avoided painkillers because they don' t solve the main problem. I would appreciate any advice you can give me. Thank you so much.
Answer 8,965 views
Headache expert
headache expert

01 Jan 0001

Dear Jesse25,

If the depersonalization started with the migraines, then there is no doubt that it is related to the migraines, even though it remains between the migraine attacks. If the migraine is successfully treated, then the depersonalization, and most likely the sleep disorder, should abate. You are 100% correct about the pain killers.

To get to the root of the problem, you need what is called a “multidisciplinary assessment”. There are so many different structures in the head and neck, all of which can be involved in the headache process, that no single specialist can have all the knowledge necessary to make a comprehensive assessment and diagnosis. For instance, a neurologist will examine the brain and nervous system, a physiotherapist will look at the muscles, a dentist will examine the teeth etc. For this reason, the “multidisciplinary assessment” combines and integrates the expertise of different specialists who would normally treat headache patients in isolation, into a single more comprehensive body of knowledge. This enables the different members of the team to provide a co-ordinated treatment plan, so that all the contributing factors are addressed.

This assessment must include a thorough examination of the head and neck muscles to determine the presence of abnormal tension, and of the external carotid vasculature to determine whether there is an arterial element to the pain.

Headache sufferers often have a poor Quality of Life due to the constant pain and associated symptoms. For a free assessment of how your headaches are affecting your Quality of Life, click on

This information has been supplied and checked by the multidisciplinary team of specialists at The Headache Clinic, in association with The International Headache Society and the South African Institute of Headache and Migraine Science. For consultation with these specialists, call The Headache Clinic (Cape Town, Durban, Johannesburg) on 0861 678 911.
The information provided does not constitute a diagnosis of your condition. You should consult a medical practitioner or other appropriate health care professional for a physical examination, diagnosis and formal advice. Health24 and the expert accept no responsibility or liability for any damage or personal harm you may suffer resulting from making use of this content.