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What Is An Aura With Migraine

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Types Of Migraine Aura

Migraine Visual Aura

Migraine with brainstem aura

This aura type involves symptoms that originate from the brainstem, which is at the base of the brain. These symptoms include :

  • Difficulty speaking
  • Impaired coordination

Brainstem aura is typically accompanied by classic aura symptoms such as flashing lights or pins and needles.

Hemiplegic migraine

Hemiplegic migraine is characterised by temporary weakness on one side of the body. Symptoms can range from weakness with numbness and tingling through to temporary paralysis in the arm and leg on one side of the body .

This type of aura can be alarming because the symptoms are similar to stroke symptoms. But unlike a stroke, the symptoms of a hemiplegic migraine come on gradually and fully resolve once the migraine attack subsides. In comparison, the symptoms of a stroke come on instantaneously and people are often left with permanent weakness.

Hemiplegic migraine can be passed down genetically, referred to as Familial Hemiplegic Migraine, or the condition can happen without any family history referred to as Sporadic Hemiplegic Migraine.

Retinal migraine

Migraine with retinal aura causes fully reversible visual disturbances in one eye, such as shimmering or flickering of vision, blind spots, or blindness. In migraine with retinal aura, the visual symptoms typically only occur in one eye .

In The Year Since Ive Experienced Migraines Anywhere From Every Two Weeks To Once In Four Months And Theyve Followed A Consistent Pattern Of Blind Spots And Visual Disturbances Before A Pounding Migraine Lasting 8

Numbness and confusion havent haunted me again, but recent episodes have come with a second round of aura 12 hours after the first, followed by an even more intense head-pounder.

Although Im sometimes guilty of staying on my laptop, common advice is to lie in a dark room until aura passes. My neurologist prescribed Excedrin with caffeine and Tylenol to take at the onset of symptoms, and sumatriptan for when the migraine starts to set in, but the pill makes me nauseous and its difficult to know whether its easing my pain or Im just experiencing a less intense migraine. Ive found codeine to be more effective for pain management, and on my worst days Ive taken all of the above.

The Aculief seemed to help ease pain during one episode, but again, its hard to know whether treatments are working or its just a lesser migraine, and ultimately my most effective move has been sleeping it off. The FDA recently approved a device that uses smartphone-controlled electronic pulses to relieve migraine pain.

As for preventive measures, magnesium supplements keep aura at bay for some, and in 2018, a new medication, Emgality, was introduced. Emgality belongs to a class of drugs called CGRP inhibitors, which aim to reduce the frequency of migraines. The monthly injections have a list price of $6,900 a year, and a common theme in reviews is that they are painful but effective.

Can Migraine Aura Increase During Pregnancy

Pregnancy can result in increased migraine aura without headaches. If youre pregnant and are experiencing a migraine with or without aura, contact your healthcare provider immediately.

A note from Cleveland ClinicMigraine aura isnt usually dangerous, but the condition can disrupt your daily life. If you experience migraine aura with or without headaches, inform your healthcare provider. Not only can they help you manage your symptoms, but they can also make sure your migraine aura isnt related to other, more troubling health problems.

Last reviewed by a Cleveland Clinic medical professional on 11/25/2021.


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What Is Migraine Aura

Migraine aura refers to a collection of symptoms that many people experience before or during a migraine attack. These symptoms can affect your senses in many ways, and some people find it to be the most debilitating part of a migraine attack.

The most common aura symptoms are visual, which people often describe as flashing lights or blind spots. Aura can also affect your senses, speech, or motor function.

This article can help you understand the symptoms, causes, and treatment of migraine with aura. Click the headings below to jump to a specific section.

Medically reviewed by Dr Trudy Cheng. Last updated June 27, 2022.

Causes Of Migraine Aura

Did You See It Coming? : Migraine Aura  Migraine Buddy

Migraine aura is believed to be caused primarily by cortical spreading depression .

Brain cells use electrical ions around the cellular membrane to maintain equilibrium. In aura, there is a temporary malfunction of this cellular balance which causes a slow wave of electrical disturbance, the CSD.

This wave of intense excitation across the visual cortex is what is thought to lead to visual aura symptoms including shimmering patches or curves, stars or blind spots etc. After the wave passes it could also cause an abnormal inhibition of activity which may explain the blind spots, partial or temporary blindness.

Neuroimaging studies show some evidence that suggest CSD leads to a temporary decrease in blood supply to certain areas in the brain. The lack of blood supply and the electrical disruptions may account for the wide and varied range of symptoms. It may also help explain differences that can be experienced by the same individual on different occasions.

Why some people have aura and others dont is likely due to several anomalies that researchers dont yet fully understand. It is hypothesized that there are several genetic factors that play a role in a patients predisposition to migraine with aura. Research is taking place to understand potential genes involved in aura which will hopefully lead to specific treatments to prevent aura.

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What Are The Different Types Of Migraine Aura

There are three main types of migraine auras:

  • Visual aura. This common type of migraine aura is characterized by temporary changes in your vision, such as flashing lights or zigzags.
  • Sensorimotor aura. Sensory or motor disturbances may include tingling, numbness or weakness, which may or may not be accompanied by visual aura.
  • Dysphasic aura. This is the least common type of migraine aura. It includes verbal and language symptoms like mumbling or slurred speech.
  • Find Out What Aura Is And How To Differentiate It From Other Migraine Symptoms Or Neurological Conditions

    Not everyone experiences migraine aura. But for those who do, aura usually acts as a warning sign for the headache pain phase of a migraine attack. While it is a distinct phenomenon, aura can be difficult to distinguish from other conditions.

    To learn more about migraine with aura, we spoke to Dr. Robblee, a neurologist and headache specialist at St. Josephs Hospital and Medical Center in Phoenix, AZ. She clarified some of the confusion surrounding aura and shared some pointers about how to recognize it accurately.

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    According To The American Migraine Foundation Migraines Affect 12% Of The Population And Of Those Patients 25

    The sensory disturbances can include blind spots, speech difficulty, numbness, and confusion, and the trippy nature of the visual disturbances is said to have inspired famous pieces of art. Aura typically lasts 20-60 minutes before a migraine kicks in, although some patients suffer aura without subsequent head pain.

    We believe that cortical spreading depression is the reason why you have an aura, says Cathy Glaser, executive director of the Migraine Research Foundation, which raises money to fund research, improve treatments, and finds causes and cures for migraines. Its an electrical force that goes through your brain and the result is aura. What causes that is still unknown.

    What Causes Migraine With Aura

    Lean About Migraine Aura

    It is not known exactly what causes auras.

    Scientists have looked into it and found that it may be caused by a slow wave of altered brain activity called cortical spreading depression. This leads to temporary changes in the chemicals, nerves and blood flow in the brain that affect how it works and could be related to pain.

    Improving understanding of how these changes in the brain can lead to headache will help with the discovery of new drugs that could prevent migraine attacks.

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    Can I Have A Visual Migraine Without A Headache

    Definitely. It is actually very common to have a visual migraine without any headache. The medical term for this is acephalgic migraine, which literally means migraine symptoms without headache. Except for the absence of a headache, the visual symptoms in acephalgic migraine are identical to the episodes that accompany a classic migraine aura.

    What To Expect From Your Doctor

    Your doctor is likely to ask you a number of questions, including:

    • When did you begin having symptoms?
    • What types of visual symptoms or other sensations do you have?
    • How long do they last?
    • Are they followed by a headache?
    • If you have headaches, how often do you get them and how long do they last?
    • How severe are your symptoms?
    • What, if anything, seems to improve your symptoms?
    • What, if anything, appears to worsen your symptoms?

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    Risk Factors And Complications

    Like migraines without aura, migraines with aura dont appear to cause lasting damage, although they can be painful and disruptive.4 However, people who experience migraines with aura may have a slightly higher risk of stroke, and so should be aware of the signs.2,5

    You should also consult a doctor when you first experience aura symptoms, as some of these can also be caused by a stroke, retinal tear or other serious conditions.2

    Migraines are also more common in women than in men, and in people who have a family history of the condition.2

    How Do You Diagnose Auras

    Did You See It Coming? : Migraine Aura  Migraine Buddy

    Since auras can cause such a broad range of systems, and sometimes donât even give you a headache, itâs no wonder that itâs not easy to get the right diagnosis.

    Thatâs why itâs so important to speak to a doctor who understands migraine and can recognize symptoms that are easy to mistake for other conditions.

    If you think you might have migraine with aura, it can be helpful to keep a headache diary.

    We recommend taking note of:

    • when your migraine started
    • which medications you used to alleviate the pain
    • what triggers you think were involved in your attack

    A doctor can’t really see your migraine symptoms, so keeping a record can make it easier for them to tell whatâs going on, and help you get diagnosed and treated faster.

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    Types Of Migraine With Aura

    Aura can happen in four types of migraine:

    • Migraine with aura . This is also called a classic migraine.
    • Migraine with brainstem aura. This is when the aura starts in the base of your brain or both sides of your brain.
    • Hemiplegic migraine. In this rare type, aura causes weakness on one side of your body .
    • Retinal migraine. You have vision changes in one eye before the migraine begins.

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    Lifestyle Changes For Aura Migraines

    Preventing aura migraines is better than having to treat them. As weve seen, some of the triggers behind the condition are within your control.

    Consider the following lifestyle changes to reduce the risk of suffering these migrainesand all migraines in general.

    • Get 7 to 9 hours of sleep every night. Have a consistent sleep routine, going to bed and waking around the same hours every day.
    • Avoid processed foods and food additives.
    • Eat a healthy and balanced diet that contains fruits, vegetables, and healthy fats.
    • Take supplements including a full spectrum eye health supplement.
    • Reduce stress through yoga, mediation, and aerobic exercise.
    • Limit your consumption of alcohol and caffeine.
    • Quit smoking if you can.
    • Pay attention to your migraine triggers. Whether they are strong light, intense smells, or particular foods, recognize them and avoid them.
    • Drink enough water every day to stay hydrated.
    • If youre taking any medication that may increase the risk of migraines, discuss with your doctor possible replacements.
    • Take care of your eyes. Patients with migraine are more likely to have dry eyes. According to the same study, dry eye syndrome may make migraine attacks worse.

    When to see a doctor: When migraines reoccur, last for more than an hour, or affect only one eye.

    When To Seek Professional Treatment

    Migraine Visual Aura – How it may happen…

    Many symptoms of migraine with aura mimic other more severe neurological disorders such as strokes and transient ischemic attack , 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
    • Symptoms that last longer than 60 minutes or don’t stop at all

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    What Is A Migraine Aura

    Migraine aura is considered a warning stage that sometimes occurs before the onset of a migraine headache. Migraine aura refers to any number of sensory disturbances, including dots, sparks or zigzags in your vision. Some people experience tinnitus, dizziness or even the inability to speak clearly.

    This condition may occur prior to or during a migraine attack usually 30 to 60 minutes prior to the head pain. It’s important to note that migraine aura doesn’t happen during every migraine episode.

    What Does Migraine Aura Look Like

    There are many different types of visual aura symptoms, and they can sometimes be difficult to describe. One research review identified up to 25 distinct visual symptoms, ranging from blurry vision to fractured mosaic vision .

    If youre still confused about what visual aura actually looks like, you can watch the videos below. They depict a scintillating scotoma. This is a common visual symptom in which a flickering, blurred spot appears in your vision and moves outwards.

    Many people have also used art as a way to document and share their experiences. Some have done this methodically, drawing the movement of a symptom across their visual field over time. Others have taken abstract approaches to express their aura symptoms.

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    What To Know About Migraine With Aura

    Doctors and patients alike have been fascinated and puzzled by how migraine and aura go hand in hand. In fact, when diagnosing an individual with migraine, people may fall into the category of migraine with aura or migraine without aura, or both. Often described as a warning sign, the aura stage of migraine is unique because it is only experienced by 25 to 30% of people with migraine.

    How Is Migraine Aura Diagnosed

    Do you get migraines with aura? What auras do you experience with your ...

    To rule out more serious conditions, such as a transient ischemic attack or mini stroke, your healthcare provider will perform a physical examination. They may also run certain tests to confirm your diagnosis. These tests may include:

    • An eye exam. This test helps rule out any eye conditions that could be causing aura symptoms.
    • A CT scan of your head. This scan takes detailed images of your brain.
    • Magnetic resonance imaging . This test uses magnets and radio waves to capture images of your tissues, organs and structures inside of your body.

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    What Are The ‘red Flags’ That My Visual Symptoms Are Not Due To Migraine

    The typical symptoms of a visual migraine are positive, meaning that there is something shimmering or sparkling that is disrupting the vision. Migraines are less likely to cause “negative” symptoms of pure visual darkness. An episode of visual darkness typically requires additional evaluation for other conditions, including a mini-stroke .

    What Are The Acute Treatments For Migraine

    An isolated visual migraine, without headache, typically does not require any acute treatment, since the visual symptoms resolve on their own fairly quickly. The first few times someone experiences a visual migraine it usually causes a lot of anxiety. Once someone has become familiar with the symptoms of a visual migraine, new episodes no longer cause the same level of anxiety.

    It can be helpful to try to rest during the episode. Some patients benefit from other strategies, including eating something, having caffeine, or taking an over-the-counter medication such as acetaminophen or ibuprofen .

    Patients in whom the visual symptoms are accompanied by a severe headache often benefit from additional therapies. The goal of these medications is to try to cut short the headache before it becomes too severe. Some patients find naproxen , which is a stronger anti-inflammatory medication, to be helpful. Other patients try a class of medications known as triptans.

    Triptans are specially designed to work on receptors on blood vessels and brain cells in order to halt a migraine at an early stage. Although there are a number of different triptans, made by several different pharmaceutical companies, each of these is approximately equally effective. Triptans are often taken orally, but also come as injections and nasal sprays. These medicines are generally not considered safe in patients with a history of strokes, heart attacks, or other vascular diseases.

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