What Is a Migraine Aura?

Migraine headaches can cause many symptoms in addition to the typical throbbing, pulsing, or pounding head pain. You can also experience a cluster of neurological symptoms known as migraine auras. Up to 25% of people with migraine have migraine with aura, according to the National Library of Medicine.

If you get migraines or suspect you do, here’s what you should know about migraine aura.

How Is a Migraine Different From Other Headaches?

A migraine is a type of headache that’s caused by a neurological disorder. It’s different than the tension headaches many people get from time to time.

About 12% of Americans experience migraines, according to the National Library of Medicine. To know if you are one of them, it helps to know the difference between a migraine and a tension headache.

“The hallmark of migraines is that they are debilitating,” says David Sacco, MD, of Moon Medical Associates-UPMC. “They often result in people having to lie down or interrupt daily activities like home responsibilities or work. A pearl I always give medical students is that the vast majority of headaches are tension headaches, but if a headache causes you to visit the doctor, it’s usually a migraine,” says Dr. Sacco.

Migraine symptoms

Migraine symptoms are more severe and last longer than tension headaches. Symptoms of migraine can include:

  • Throbbing, pulsing, or pounding pain. It’s typically on one side of your head but can shift or affect both sides.
  • Head pain that gets worse when you move, sneeze, or cough.
  • Head pain that lasts anywhere from four to 72 hours.
  • More than one episode — or migraine attack — over several days.
  • Upset stomach, nausea, or vomiting.
  • Sensitivity to light, sound, or smells.
  • Muscle weakness.

Tension headache symptoms

Tension headaches are the most common headache disorder. More than 70% of people experience tension headaches, according to the World Health Organization. Symptoms of tension headaches include:

  • Mild to moderate pain in your head, face, or neck.
  • A dull pressure, often surrounding your head.
  • Pain that lasts for less than four hours.
  • No other symptoms.

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What Is a Migraine Aura?

Migraine aura is a set of symptoms that can affect your vision, hearing, nervous system, or motor skills. A migraine aura lasts anywhere from five to 60 minutes, according to the American Migraine Foundation.

In most cases, these symptoms serve as a warning sign that a migraine is about to begin, usually within an hour. But you can also get aura symptoms after a migraine headache begins. And some people have aura without developing a migraine headache.

Visual auras

Visual auras or disturbances are the most common type of migraine aura. These disturbances often involve both eyes. Symptoms of visual aura include:

  • Seeing flashing or flickering lights, jagged arcs of light, or bright lines.
  • Blind spots in your visual field.
  • Temporary vision loss.

Other auras

Other types of migraine aura and symptoms include:

  • Sensory aura. This includes tingling or numbness in your mouth, hands, or feet.
  • Auditory aura. This includes hearing disturbances, such as tinnitus (ringing in the ears), or hearing music or other noises.
  • Language, or aphasic, aura. This type of aura is rare. If you have this, you may have difficulty finding or understanding words. Or when you speak, the words come out wrong.
  • A motor aura that can cause you to feel weakness on one side of face or body. Also known as a hemiplegic migraine, this is a very rare form of aura.

When Should You See Your Doctor?

With or without migraine aura, if you get migraines often, you should see your doctor to rule out any other causes. For specialized treatment, you may need to see a neurologist, a doctor who treats migraines and other neurological disorders.

Other reasons to schedule an appointment with your doctor include:

  • Your migraine pain or patterns change.
  • You need to take over-the-counter (OTC) medicine more than three days per week.
  • You are taking birth control pills and start having migraines.
  • Your headaches are worse when you’re lying down.

Treating Migraine With Aura

During a migraine attack, you can treat pain and symptoms at home using OTC medications, lifestyle changes, and relaxation techniques.

If treating your migraine at home doesn’t work, you may need a prescription medication. Some prescription medications help prevent migraines and some help manage migraine symptoms.

Preventing Migraine Aura

It’s possible to prevent some migraines, including migraines with aura,

by making important lifestyle changes or taking medication.

Lifestyle changes

Lifestyle changes to prevent migraine symptoms, including aura:

  • Getting enough quality sleep.
  • Staying hydrated.
  • Eating regular meals.
  • Getting regular exercise.
  • Reducing stress.

“Migraines often have triggers – stress, visual stimuli like strobe lights, alcohol, or certain foods. Patients should try to identify and minimize these triggers. Migraine triggers are as unique as the people that have migraines – something that doesn’t bother one person at all can trigger a full-blown migraine in others. Any headaches that are new or changing in character should prompt a visit to the doctor,” says Dr. Sacco.

Medication therapy

Medication you take regularly to prevent migraine is known as prophylactic therapy.

Prophylactic treatment isn’t a cure, but it can help reduce how often and how many migraines you get — which can help prevent migraine with aura.

Prophylactic therapy may include prescription medications such as:

  • Beta-blockers, such as metoprolol or propranolol.
  • Antidepressants, such as amitriptyline or venlafaxine.
  • Anticonvulsants, such as valproate or topiramate.
  • Calcium channel blockers, such as verapamil or flunarizine.

You may need to schedule a follow-up appointment with your doctor or neurologist if:

  • You have side effects from your prescription medication.
  • Your treatment has stopped working.
  • You are pregnant or could become pregnant. You can’t take certain migraine medications during pregnancy.

Complications of Migraine with Aura

Migraine with aura can cause serious complications, including:

Migrainous infarction or stroke

Having a migraine with aura doubles your risk of ischemic stroke compared to someone without migraine. That’s according to a medical literature review in the Journal of Neurology, Neurosurgery, & Psychiatry. When you have an ischemic stroke along with migraine with aura, it’s known as a migrainous stroke.

You’re at an even greater risk of migrainous stroke if you experience auras that include loss of vision or speech problems.

According to the definition by the International Classification of Headache Disorders version 3 (ICHD-3), a migrainous infarction or stroke must include:

  • A migraine attack with aura that lasts 60 minutes or more.
  • A migraine with one or more aura symptoms.
  • An infarction seen on brain imaging.
  • A stroke that is not attributed to another disorder.

Migrainous strokes are rare. They make up less than 1% of all ischemic strokes, according to that literature review.

Migraine-aura triggered seizure

Seizures triggered by a migraine attack with aura often occur within an hour after a migraine attack.

When Migraines Are Emergencies

Call 911 or have someone drive you to the emergency room if you have any signs of a stroke or seizure. You should also call 911 or have someone take you to the emergency room if:

  • You develop a sudden headache or a severe headache that feels like your head is going to explode.
  • You are having “the worst headache of your life.”
  • You have speech, vision, or movement problems, especially if you’ve never had these symptoms with a headache before.
  • You have a loss of balance or weakness, especially if you’ve never had these symptoms with a headache before.
  • You have a fever along with your migraine or any other headache.
  • You have aura symptoms that last for a week or more after your migraine has ended.

Migraine with Aura. StatPearls. National Library of Medicine. Link.

Demystifying Migraine with Aura. American Migraine Foundation. Link.

Types of Aura. American Migraine Foundation. Link.

Migraine and Risk of Stroke. Link.

Migrainous Infarction: A Rare and Often Overlooked Diagnosis. Autopsy Case Reports. Journal of Neurology, Neurosurgery, & Psychiatry. Link.

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