The following can be triggers to a migraine attack and thus can be triggers for the scintillating scotoma or scotomata. 1  Alcohol. 2  Stress. 3  Anxiety. 4  Chemicals such as perfumes.  Smoking or second-hand 1  smoke. Bright lights.  Caffeine 1  withdrawal. Hormonal changes as in the monthly menstrual cycle, or oral contraceptive  usage.