A migraine with aura (also called a "classic migraine") is a migraine with temporary sensory disturbances. These disturbances can occur just before or simultaneously with the migraine.
Symptoms of aura can range in severity and may be similar to symptoms that accompany more serious neurological events, such as a stroke or brain tumor. It is important to consult your healthcare provider about your symptoms to rule out other causes and get an official migraine with aura diagnosis.
There are no medications or therapies targeted specifically for preventing or treating auras, so in most cases, migraine with aura is treated the same way as migraine without aura.
Symptoms
Migraine with and without aura share many of the same symptoms. The primary symptom of both is a throbbing or pulsing pain that typically affects just one side of the head and can be severe. Other common symptoms of migraine include nausea and vomiting, sensitivity to light or sound, dizziness, and neck pain.
![Migraine With Aura Symptoms](https://www.verywellhealth.com/thmb/us0qfBAt4v2Sl1ZPf2Iiii5x0V4=/1500x0/filters:no_upscale():max_bytes(150000):strip_icc():format(webp)/migraine-with-aura-headache-4171966_final-eea05337858e4084b6a3b917d131f4ff.jpg)
Verywell / Brianna Gilmartin
Migraine with aura is experienced by 25% to 30% of people with migraines. Auras can last as few as five minutes. Most clear up within 60 minutes, often disappearing before head pain sets in, although sometimes they occur simultaneously.
Visual Aura
Visual disturbances are the most common among migraine with aura symptoms; between 98% and 99% are visual, while symptoms affecting sensation and speaking occur in 36% and 10% of aura, respectively.
Visual auras can look like simple geometric shapes, zigzag or wavy lines, shimmery spots or stars, sparkles or flashes of light that move or get larger, changes in vision, or vision loss. Often visual auras start in the center of the field of vision and spread outward.
Sensory Aura
A sensory aura might be tingling or pins-and-needles in an arm or leg, for instance, numbness in the face or on one side of the body. These sensations sometimes travel up one arm to one side of the face.
Auditory Aura
A person may hear noises or music, or experience ringing in the ears.
Aphasic Aura
This refers to difficulty talking, having trouble coming up with a specific word, or producing a word you know you want to say. It may also manifest in being unable to understand what others say.
Motor Aura
This type of aura is rare but may be characterized by an inability to move a part of the body.
When Do Auras Happen?
An aura typically occurs within an hour of when head pain begins and so for many people, it serves as a warning that a migraine headache is likely to happen.
In some instances, a headache may not follow an aura—what's known as an acephalgic, or silent migraine.
Causes
The exact cause of migraine isn't clear but certain brain chemicals play a role. A wave of nerve cell activity in the brain releases neurotransmitters that change blood vessel size and trigger inflammation and pain.
There are hypotheses that auras occur when a wave of nerve cell activity moves across part of the brain that processes signals from different senses. There is no certain explanation for why the actual visual symptoms appear the same across people.
Many of the same causes that trigger migraine without aura are also triggers for migraine with aura. Some of these triggers include:
- Stress
- Hormonal fluctuations (such as those that occur during menstruation)
- Caffeine
- Alcohol
- Nitrates, and other foods and food additives
- Some medications
- Head trauma
- Bright or flashing lights
There is also a genetic link to migraines. You have a 50% to 75% chance of having migraines if one or both of your parents have migraines.
Diagnosis
Diagnosis of migraine with or without aura is based on a review of your symptoms, medical history, and a physical exam.
Your healthcare provider may order additional testing to rule out other causes depending on the severity and type of symptoms. A blood test or spinal tap (lumbar puncture) can be used to check for an infection of the brain or spinal cord, while an imaging test (CT scan or MRI) can help look for tumors, strokes, or brain damage.
Women who have migraine with aura have a slightly increased risk of stroke, especially if they smoke or take birth control pills.
If you have severe head pain along with visual or other types of symptoms that you suspect is migraine with aura, it's important to have your healthcare provider assess your condition. Migraine with aura can mimic other conditions such as a transient ischemic attack, stroke, or seizure.
Getting an official diagnosis of migraine with aura also is important for distinguishing this type of migraine from another type called retinal migraine (sometimes called "one-eye migraine"). This occurs when visual symptoms affect only one eye and are caused by a spasm of blood vessels in the retina.
Prevention
Preventing migraine involves taking measures to avoid known migraine triggers and medications to manage headache pain and other symptoms.
Acupuncture may be helpful. In a 2016 review of studies looking at the effectiveness of this ancient Chinese medical practice for preventing migraine, acupuncture was found to "be at least similarly effective as treatment with prophylactic drugs."
Treatment
Medications
There are several medications available to help relieve migraine headaches and other general migraine symptoms. Once these take effect, a lingering aura should subside along with pain. There are also medications to prevent migraines.
Pain-Relievers
Over-the-counter (OTC) pain relievers including non-steroidal anti-inflammatory medications (NSAIDs) and acetaminophen (Tylenol) can help reduce headaches.
Antiemetics (anti-nausea medications)
These help to relieve nausea and vomiting associated with migraines and include drugs like domperidone and metoclopramide.
Dopamine-receptor antagonists
These agents block dopamine (a neurotransmitter) from activating certain brain cells. These may also be used to relieve nausea and vomiting associated with migraines especially as part of emergency treatment, in which case they're given intravenously or by injection.
Examples include:
- Thorazine (chlorpromazine)
- Compro (prochlorpromazine)
- Reglan (metoclopramide)
- Inapsine (droperidol)
Calcitonin Gene-Related Peptide Inhibitors (CGRPs)
This class of medications works by blocking CGRP, a brain protein found in higher levels among people with migraines, from attaching to a brain receptor. These are now recommended as the first line of treatment for preventing migraines.
Some of these include:
- Nurtec ODT (rimegepant)
- Qulipta (atogepant)
- Ubrelvy (ubrogepant)
- Zavzpret (zavegepant)
- Aimovig (erenumab)
- Reyvow (lasmiditan)
Triptans
Triptans are prescription drugs that work by narrowing blood vessels in the brain and reducing inflammation. These can help to relieve pain and reduce nausea and light sensitivity. Triptans used for migraine include:
- Amerge (naratriptan)
- Imitrex (sumatriptan)
- Relpax (eletriptan)
- Treximet (sumatriptan and naproxen)
Dihydroergotamine
Available as Migranal, this medication is in a drug class called ergot alkaloids. It helps head off migraines by tightening blood vessels in the brain and preventing the release of substances that cause swelling. It can be injected subcutaneously, usually in the thigh well above the knee, or taken as a nasal spray.
Medications to prevent migraines were originally developed for other conditions.
These medications are prescribed for frequent migraines (more than twice a week) and need to be taken daily.
These include:
- Antihypertensives (beta-blockers)
- Antidepressants
- Anticonvulsants
- Botox (botulinum toxin type A)
Magnesium
Evidence suggests magnesium can help control pain symptoms in migraine with aura. Some health professionals recommend taking magnesium to help with migraine prevention as well, but you should speak with your healthcare provider about your medical history before starting any supplements.
Modifications
If an aura is prolonged or continues even after head pain sets in, these steps may help you to better cope with any sensations you're having:
- If light exacerbates a visual aura, lie in a dark room or wear sunglasses.
- Seek a quiet place if noise bothers you.
- If you experience an aura that affects your balance or ability to move, ask someone to help you get somewhere you can sit or lie comfortably.
- Stay hydrated.
- Apply an ice pack or cold cloth on your forehead.
Summary
Migraine with aura can be debilitating enough to have a negative effect on your quality of life. You may feel isolated because the unpredictability of your migraine attacks makes it difficult to plan social events. Frequent migraine attacks may also impact your work and relationships.
It is important to consult with a healthcare provider to get an official diagnosis of migraine with aura and to rule out other serious health conditions. Although there is no cure, there are preventative treatments, medications, and lifestyle changes to help alleviate migraine with aura symptoms.