What to Know About Migraine Auras

Auras are visual or sensory disturbances that can occur during or right before a migraine starts. Symptoms of migraine auras range from seeing dots to flashes to sparks. People who experience them usually find them somewhat startling, alarming, and even temporarily disabling. About one-third of people who experience a migraine will have auras.

This article discusses the different types of auras and the symptoms they can cause. It also covers how migraines with auras are diagnosed and treated.

What Is a Migraine With Aura?

Migraines, or migraine headaches, are a neurological disorder that affects 10% of the general population and is a leading cause of disability worldwide. Although migraines have a long history, our full understanding of migraines continues to be incomplete.

Migraine with aura is a little different than a typical migraine headache. They are characterized by the appearance of visual or sensory disturbances before the migraine starts. Auras appear due to changes in brain activity, and they may occur at the same time as a migraine headache or before the headaches starts.

Unlike migraines without aura, migraines with aura are associated with stroke, hypertension, and smoking.

What Are the Types of Auras?

The different types of auras include:

• Visual
• Sensory
• Speech/language
• Hemiplegic migraine (migraine with weakness on one side of the body)
• Migraine with brainstem aura (symptoms such as vertigo, double vision, slurred speech, and decreased level of consciousness)
• Retinal aura (visual symptoms in one eye)

Each kind of migraine with aura may have different symptoms.

What Are the Symptoms of Migraines With Auras?

Migraines with aura affect different senses and bodily functions.

The main symptoms include:

• Visual symptoms: Visual symptoms are the most frequently reported. Up to 99% of people who experience migraine with aura report visual symptoms. These symptoms can include seeing black dots, flashes of light, blind spots, and zigzag lines, or things may appear closer or farther away than they actually are.
• Sensory symptoms: Sensory symptoms include feeling numbness or tingling anywhere on the body, particularly the face, hands, and fingers.
• Speech and language symptoms: Speech and language symptoms include slurred speech, inability to form words, mumbling, and difficulty speaking.
• Motor weakness: In some instances, motor weakness will occur. This may appear as muscle weakness or even temporary paralysis on one side of the body. This type of migraine aura is known as a hemiplegic migraine.

There are also general symptoms that both migraines and migraines with aura share.

The typical symptoms of migraine include:

• Throbbing or pulsing pain in the head
• Nausea
• Vomiting
• Dizziness
• Sensitivity to light and sound

Signs and symptoms of migraine auras vary widely among the people who experience them, and even from one attack to the next.

Diagnosing Migraines With Auras

To diagnose migraine with aura, a physician or a neurologist (who specializes in disorders of the brain and spinal cord) will take a detailed medical history and conduct a physical exam.

Tests may be ordered, including an MRI (magnetic resonance imaging) to see images of the brain. Other imaging tests like CT (computed tomography) scans or angiography (a type of X-ray that checks blood vessels) may also be used.

Migraines run in families, so your healthcare provider will want to get a detailed family history as well.

How Are Migraines With Auras Treated?

Treatment options usually include medications that will help immediately as a migraine with aura starts (known as acute medications), along with medications taken regularly to slow or prevent migraine with auras altogether.

Some of these medications include:

• Over-the-counter (OTC) medications: Known as analgesics, these work well for mild migraine symptoms. They include NSAIDs (nonsteroidal anti-inflammatory drugs), such as Advil or Motrin (ibuprofen), or Tylenol (acetaminophen). Medications that combine pain relieving analgesics with caffeine (such as Excedrin) may also provide relief.
• Prescription medications: When migraines are more than mild or don't respond to OTC pain relievers, a healthcare provider may prescribe an acute medication designed to block pain receptors, such as triptans or ergot alkaloids for severe migraines.
• Preventive medications: When people experience more than four migraines per month, an ongoing preventive migraine medication may be needed. These include anticonvulsants, antidepressants, and antihypertensives.
  

When to Seek Professional Treatment

Many symptoms of migraine with aura mimic other more severe neurological disorders such as strokes and transient ischemic attack (TIA, also called a ministroke), which is a temporary condition with symptoms that strongly resemble a stroke. TIAs may indicate a high risk for stroke.

You should seek immediate medical attention if you experience any of the following:

• Weakness on one side of the body
• Slurred speech
• Vision problems
• Symptoms that last longer than 60 minutes or don't stop at all
  

Ways to Prevent Migraine With Auras

It can be difficult to predict migraines, and it may even be impossible to prevent them. However, there are many potential triggers that can cause migraines, including certain foods, the weather, alcohol, and hormonal changes. Track your migraines with these details in mind to identify triggers that you can avoid in the future.

There are a few lifestyle factors related to migraines with aura:

• Diet: Alcohol, caffeine, and certain foods (particularly processed foods) can trigger a migraine.
• Environment: Changes in the weather, excessive noise, flashing lights, or strong odors can bring on a migraine.
• Hormonal: Women may experience migraines and migraines with aura prior to their menstrual cycle. They also occur in women during ovulation, pregnancy, and menopause.
• Stress: Stressful events or daily chronic stress that builds up over time can lead to migraines.
• Sleep: Poor or insufficient sleep may cause migraines.

In some cases, multiple factors may occur before the start of migraine or migraine with aura. The wide variety of potential triggers can make both predicting and preventing migraines sufficiently challenging.

Summary

Migraine auras are visual or sensory disturbances that occur before a migraine starts. They might include seeing black spots or flashes of light, or you might feel numbness or muscle weakness. They can last from five minutes to an hour or sometimes longer.

Your healthcare provider may diagnose a migraine with aura with a physical exam, MRI, or CT scan. Treatment can include OTC or prescription medications. To prevent migraines with auras, try to avoid triggers, such as certain foods, flashing lights, or inadequate sleep.