Migraine Auras Overview

Migraine auras are sensory symptoms that can occur before or during a headache. They tend to take the form of visual and physical disturbances or sensations.

Migraine with aura is a type of migraine headache. Common symptoms include tunnel vision, seeing stars, and tingling sensations in the hands or feet. Of those who experience migraine headaches, 25–30% experience additional aura symptoms.

Migraine aura symptoms usually appear over a period of at least 5 minutes and tend to last for up to 60 minutes. Some people describe a migraine aura as a “warning sign,” as its symptoms often develop before a headache.

What is a Migraine Auras?

Migraine auras can take on one of three main forms: visual disturbances, physical sensations, and speech or language difficulties.

Visual disturbance auras

Some examples of visual changes associated with migraine aura include seeing:

  • Blind spots, called scotomas
  • Colored spots
  • Flashes of light
  • Stars or sparkles of light
  • Tunnel vision
  • Zigzag lines

These often start in the center of a person’s field of vision before moving outward. People may also experience temporary vision loss or blindness during a migraine episode.

Physical Sensation Auras

For some people, auras involve physical sensations, such as tingling, numbness, and dizziness. These sensations may start on one side of the body before spreading slowly to other areas.

Physical aura sensations can include:

  • A feeling that body parts are larger than they really are
  • Dizziness
  • Muscle weakness on one side
  • Numbness or tingling sensations
  • Pins and needles in the arms and legs
  • Vertigo (spinning dizziness)

Speech or Language Difficulty Auras

During a migraine episode, some people may find it difficult to speak or communicate with others. They may have difficulty finding the right words to use, or they may mumble or slur their speech.

Other Symptoms

Along with these other sensations, migraine aura may cause:

  • Confusion
  • Feelings of fear
  • Memory changes
  • Partial paralysis or fainting, in rare cases
  • Smelling something that is not there


Types of Migraine with Aura

Around 30% of patients who experience migraine headaches also experience migraine with aura. However, some subtypes of migraine are particularly likely to involve auras.

Specialists have previously referred to migraine with aura as classic migraine, focal migraine, aphasic migraine, and complicated migraine.

Other rare types of migraine that cause auras include:

Hemiplegic Migraine

This is a rare type of migraine that involves temporary weakness or paralysis on one side of the body. Other symptoms include pins and needles and numbness. The weakness typically goes away within 24 hours, but it may last for several days.

According to the National Organization for Rare Diseases, researchers do not know the true prevalence of hemiplegic migraine. However, some research suggests that it affects around 1 in 10,000 people.

Migraine with Brainstem Aura

Migraine with brainstem aura, formerly known as basilar-type migraine, is rare.

The most common symptoms appear to be:

  • Double Vision, called diplopia
  • Ringing in the ears, called tinnitus
  • Slurred speech
  • Vertigo

The researchers conclude that migraine with brainstem aura may occasionally happen to anyone who experiences migraine with aura.

Retinal Migraine

Retinal migraine is another rare subtype of migraine aura. It affects vision in one eye only. It may cause temporary blindness or the appearance of flickering lights in that eye.

Causes of Migraine Auras

Medical professionals do not fully understand the exact cause of migraine headaches.

Migraine with visual aura may occur when a wave of electrical activity moves across the visual cortex of the brain, which is the part that processes visual signals.

Triggers of Migraine Auras

Triggers for migraine with aura are the same as triggers for migraine without aura and include:

  • Alcohol consumption, especially wine consumption
  • Caffeine consumption
  • Exposure to bright lights or strong sun
  • Food and food additives, such as aged cheeses, processed foods, and monosodium glutamate
  • Hormonal fluctuations in females (due to pregnancy, menstruation, or oral contraceptives, for example)
  • intense physical activity or overexertion

Other Triggers

  • Lack of sleep or too much sleep
  • Medications, such as the use of oral contraceptives or vasodilators for high blood pressure
  • Stress
  • Strong smells, such as that of smoke, perfume, or gasoline
  • Weather changes or barometric pressure changes


Risk Factors of Migraine Auras

Factors that increase the risk of developing migraine, including migraine with aura, include:


Treatment of Migraine Auras

The treatment options for migraine with aura are similar to those for other types of migraine. Treatment depends on the frequency and severity of a person’s symptoms and may include:

Medications

The following over-the-counter (OTC) and prescription medications can help treat migraine with aura:

  • Anti-inflammatory pain relievers, such as aspirin or ibuprofen (Advil, Motrin IB)
  • Migraine relief medications, such as Excedrin Migraine
  • Anti-nausea medications to reduce nausea and vomiting
  • Dihydroergotamines, in the form of a nasal spray or injection
  • CGRP receptor antagonists such as Nurtec and Ubrelvy
  • Triptans, such as sumatriptan (limiter, Tosymra, or rizatriptan (Maxalt), to block the brain’s pain signals

Medical Devices

Some medical devices, such as single-pulse transcranial magnetic stimulation devices, may help reduce migraine pain by stimulating the brain in specific ways.

These devices use pulses of magnetic energy. People must place them on the head for a few moments to see results.

Research indicates that these devices can reduce the severity of migraine episodes. However, they are not suitable for everyone and are only available with a prescription.

Home Remedies

Home remedies may help alleviate some migraine symptoms, while lifestyle changes can help prevent onset.

 These may include the following:

  • Lying down in a quiet, cool, dark room
  • Taking a nap when symptoms first appear
  • Placing a cool compress or ice pack on the forehead or back of the neck


Lifestyle Changes

Lifestyle changes that may help prevent migraine episodes include:

  • Avoiding migraine triggers, where possible 
  • Drinking plenty of water and limiting or avoiding caffeine and alcohol
  • Eating a balanced diet that is low in processed foods and food additives
  • Practicing stress reduction techniques, including yoga, deep breathing exercises, and progressive muscle relaxation exercises
  • Sticking to a consistent sleep routine, with the same bedtime and wake time every day

For severe or recurrent migraine episodes, it is usually most effective to use medical treatments alongside home care strategies.

Seeking Medical Help

Patients who experience symptoms of migraine with aura should speak with their doctor as soon as possible.

It is best not to assume that these symptoms are related migraine unless you have already discussed your auras with your doctor and they have ruled out other conditions.

Individuals should also contact a doctor if the symptoms:

  • Last for longer than 1 hour
  • Occur in only one eye
  • Does not completely resolve with time

In these cases, a doctor will likely perform tests to rule out more serious conditions, such as stroke or retinal tear.

Summary

Migraine with aura can be uncomfortable and debilitating, but it is not life threatening. However, these symptoms can be concerning, and a healthcare professional should rule out other neurological causes before attributing aura symptoms to migraine.

Patients who experience recurrent or severe migraine headaches may require prescription medications or medical devices to manage their symptoms and help prevent future episodes.

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