How to Recognize a Migraine Aura

"Spotting the Signs: How to Recognize a Migraine Aura"

Have you ever experienced flashing lights, blind spots, or zigzag lines in your vision before a headache strikes? If so, you may be familiar with migraine aura. Migraine aura is a neurological phenomenon that occurs in about 25% of people who suffer from migraines. It typically lasts anywhere from 5 to 60 minutes and can include a range of visual, sensory, or motor disturbances. While migraine aura can be frightening and disruptive, it is generally not considered dangerous and can be treated with medication and other management strategies. If you experience migraine aura, it is important to talk to your healthcare provider about the best ways to manage your symptoms and prevent future attacks.

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Migraine aura is a group of symptoms that can occur before or during a migraine attack. These symptoms may include disruptions in vision, sensation, or speech. It is estimated that between 25 and 30 percent of people who experience migraines also experience an aura.

One important thing to note is that an aura can act as a warning sign of an impending migraine attack. This can be helpful in allowing individuals to take preventative measures or manage their symptoms more effectively.

Most often, the aura begins about an hour before the onset of migraine pain and lasts less than 60 minutes. However, it’s important to note that not all migraine attacks include an aura. If you experience migraine symptoms, it’s important to consult with a medical professional to determine the best course of treatment for your individual needs.

Read more: Understanding and Recognizing Pre-Migraine Symptoms

What are the typical symptoms of a migraine aura?

Aura can cause a variety of different symptoms.

Visual symptoms

A visual aura is the most common type of aura. Some of the symptoms you may experience during a visual atmosphere include:

  • Seeing zigzag flashes of light, stars, or bright spots
  • Squiggly lines or geometric shapes in your field of vision
  • Partial vision loss or blind spots (opalescence)

Sensory symptoms

It’s important to note that aura can sometimes cause alterations in sensation. These particular symptoms can manifest whether or not there is a visual aura present. When it comes to sensory aura, the most common symptoms include numbness, tingling, or a sensation similar to being pricked by needles. This tingling sensation may begin in one arm and then spread upwards. It’s also possible to experience this feeling on one side of your face, lips, or tongue.

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Speech and language symptoms

Disturbances in speech and language are less common aura symptoms. Symptoms may include:

  • unclear
  • mumbling
  • Inability to form the correct words

Signs and symptoms of pre-existing headache

It’s important to understand that migraine attacks have multiple phases, with the pre-migraine or prodromal phase being the first four phases. This phase can occur several hours to several days before the onset of the aura and the actual migraine attack.

Recognizing pre-migraine symptoms is crucial in avoiding triggers and preventing an attack. These symptoms can vary from person to person and may include:

  • constipation or diarrhea
  • depression
  • insomnia
  • irritability
  • sensitivity to light and sound
  • Mood changes
  • nausea
  • Neck and shoulder stiffness
  • trouble concentrating
  • exhaustion

While the aura occurs before or during a migraine attack, the initial phase can begin days before an attack. Prodrome symptoms may include fatigue, irritability, or neck pain.

Read more: Migraine vs. Chronic Migraine: What Are the Differences?

Can you have an aura without a headache?

It’s important to note that aura can sometimes cause alterations in sensation. These particular symptoms can manifest whether or not there is a visual aura present. When it comes to sensory aura, the most common symptoms include numbness, tingling, or a sensation similar to being pricked by needles. This tingling sensation may begin in one arm and then spread upwards. It’s also possible to experience this feeling on one side of your face, lips, or tongue.
It’s important to understand that migraine attacks have multiple phases, with the pre-migraine or prodromal phase being the first four phases. This phase can occur several hours to several days before the onset of the aura and the actual migraine attack.

Recognizing pre-migraine symptoms is crucial in avoiding triggers and preventing an attack. These symptoms can vary from person to person and may include constipation or diarrhea, depression, insomnia, irritability, sensitivity to light and sound, mood changes, nausea, neck and shoulder stiffness, trouble concentrating, and exhaustion.

It’s important to note that while the aura occurs before or during a migraine attack, the prodrome phase can begin days before the onset of the attack and may include symptoms such as fatigue, irritability, or neck pain.
It’s important to note that aura symptoms can occur without the presence of migraine pain, which is sometimes referred to as a silent migraine. These symptoms can still cause disruptions in daily activities and should be taken seriously.

Ocular migraine, which is a type of migraine attack that primarily affects vision, can also occur without pain. Both migraine with aura and retinal migraine can be considered types of ocular migraine.

It’s worth noting that migraine attacks without pain can sometimes be misdiagnosed as other conditions, such as transient ischemic attacks (TIAs) or epileptic seizures, due to their similar symptoms. It’s important to seek medical attention if you experience any unusual or concerning symptoms.

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What causes or triggers a migraine aura?

Precisely what causes corona is not well understood. It is thought to be caused by a wave of electrical activity propagating through the cerebral cortex.

Prolonged suppression of neuronal activity then follows this wave. This can lead to various changes, such as changes in blood flow, that may trigger migraine symptoms.

It’s also possible for auras to be caused by the same things that can trigger migraine attacks without aura. They can include:

  • Stress or anxiety
  • Not getting enough sleep.
  • Missing or eating irregular meals
  • Consumption of alcohol or caffeine
  • Certain foods, such as chocolate, aged cheese, and cured meats
  • Food additives such as MSG or aspartame
  • Hormonal changes, such as during menstruation
  • Bright lights, strong smells, or loud noises
  • energizing exercises
  • changes in the weather
  • some medicine

What is the best way to treat migraine accompanied by aura?

When aura symptoms begin, moving to a quiet, dark room and closing your eyes may be helpful.

Placing a cold compress on your forehead or neck may also help relieve migraine pain.

Like other types of migraine treatment, aura involves a combination of medications. These include drugs to prevent and relieve symptoms.

Preventive medications that may stop migraines from occurring include:

  • Antidepressants, such as amitriptyline
  • Blood pressure medications, such as beta-blockers or calcium channel blockers
  • Anticonvulsants, such as topiramate

Symptomatic relief medications help reduce the severity of an upcoming migraine attack. They are usually taken as soon as aura symptoms appear.

Examples of some of these medications are:

  • Over-the-counter pain relievers such as acetaminophen (Tylenol) or ibuprofen (Motrin, Advil)
  • Triptans, such as rizatriptan and sumatriptan
  • Dihydroergotamine
  • Anti-nausea medications
  • gepants such as ubrogepant (brand name Ubrelvy) or rimegepant (brand name Nurtec)
  • titans, such as lasmiditan (brand name Vyepti)

Other alternative methods of treating migraines are also being researched. These include things like biofeedback, acupuncture, and relaxation techniques.

Read more: When Should You Go to the ER for Migraine?

Are there different types of migraine attacks?

Several other types of migraine involve neurological symptoms besides pain, such as:

  • Migraine with brainstem aura. Also known as basilar migraine, this is a rare type in which aura symptoms originate in the brainstem. Symptoms can include dizziness, ringing in the ears, and problems with speech.
  • Hemiplegic migraine. A migraine attack with an aura includes weakness on one side and numbness and tingling. Hemiplegic migraines can occur with or without migraine pain.
  • Vestibular migraine. A condition that includes sudden onset of dizziness, confusion, and balance issues. Many people with vestibular migraines do not have a history of headaches.
  • Retinal migraine. Auras associated with retinal migraines cause loss of vision in one eye.

You may also be diagnosed with chronic migraine if symptoms occur 15 or more days a month.

How is migraine aura diagnosed?

To diagnose migraine with aura, a neurologist will typically review your medical history and closely examine the symptoms you’ve experienced. This clinical diagnosis requires a thorough physical examination and a detailed list of your symptoms to be accurately identified. It’s important to seek the guidance of a doctor if you suspect you may be experiencing migraine with aura.

The International Classification of Headache Disorders, Third Edition (ICHD-3), includes guidelines to help diagnose migraine with aura. Individuals must have experienced at least two migraine attacks that include these criteria:

  • Having one or more aura symptoms in these categories:
    • Ocular or retinal – symptoms affecting vision
    • Sensory – symptoms that affect the senses
    • Brain stem – an articular sign of pain in the back of the head
    • Locomotor – symptoms that affect movement
    • Speech or language – symptoms that affect words and speech
  • It has at least three of these six characteristics:
    • One or more aura symptoms that gradually spread over more than 5 minutes
    • Two or more shows together, one after the other
    • One or more unilateral aura symptoms
    • One or more positive aura symptoms
    • Aura symptoms that last from 5 to 60 minutes
    • Aura with or followed by headache within 60 minutes
  • No other diagnosis can cause these symptoms

Because there is no definitive test for migraine with aura, neuroimaging tests such as an MRI or CT scan may not be necessary for most people. But neuroimaging may be recommended if a person has other symptoms, such as:

  • Headache that does not respond to treatment
  • Changes in the number, type, or severity of headaches
  • New neurological symptoms
  • Sudden and severe headache
  • New headaches in individuals over 50 years of age or people with HIV or cancer
  • Signs or symptoms of meningitis such as double vision, nausea, vomiting, and dizziness
  • signs of a stroke, such as:
    • numbness
    • weakness in the face
    • Weakness on one side, especially in an arm or leg
    • Sudden onset of confusion or difficulty speaking or understanding speech, difficulty walking, dizziness, or loss of balance
    • Loss of vision or difficulty seeing in one or both eyes

If you have symptoms of a stroke, call 911 immediately. Have someone stay with you until they arrive.

When to seek medical attention for a migraine aura

If you have never experienced a migraine with aura and suddenly feel tingling or numbness on one side of your body, difficulty speaking, or slurred speech, it’s crucial to seek medical care right away. It’s important to note that these symptoms can also be indicators of a stroke, so ruling out a more severe condition is necessary.

Additionally, seek emergency care for any headaches:

  • It comes on suddenly and severely
  • It is accompanied by a stiff neck, fever, or rash
  • It occurs with symptoms such as confusion, convulsions, and loss of consciousness
  • It occurs after a head injury

It’s also a good rule of thumb to make an appointment with your doctor for headaches that:

  • It occurs frequently and lasts from hours to days
  • Your daily activities are disrupted
  • Occur frequently when you used to be headache-free

If you’re worried about migraines and don’t have a doctor, you can view some in your area through the Healthline FindCare tool.

Migraine Resources

Living with migraines can be challenging and can impact your daily activities. It’s reassuring to know that you’re not alone, and many others are also going through the same thing. If you’re looking for resources and support for migraines, Migraine Healthline is a great community hub that you can access through your iPhone or Android. You can also explore other migraine apps available on both platforms.

In conclusion, migraine aura is a common neurological phenomenon that affects a significant number of individuals who suffer from migraines. While it can be distressing, it is generally not considered dangerous and can be managed with medication and other strategies. If you experience migraine aura, it is important to seek medical advice to determine the best course of treatment for your symptoms and to prevent future attacks. With proper management, individuals with migraine aura can live full and healthy lives.

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