Migraine Aura

A migraine aura is a “warning stage” that sometimes occurs before the start of a migraine headache. Migraine aura refers to any number of sensory disturbances — like dots, sparks or zigzags in your vision, ringing in your ears (tinnitus), dizziness or not being able to speak clearly.

These symptoms may occur before or during a migraine attack — usually 30 to 60 minutes prior to head pain. It’s important to note that a migraine aura doesn’t happen during every migraine episode. Only about 30% of people with migraines experience auras.

Types of migraine aura

There are several types of migraine auras based on the symptoms. Some of these include

1. Visual aura: This common type causes temporary changes in your vision, like flashing lights or zigzags.
2. Sensorimotor aura: These may include feeling a tingling sensation, numbness or weakness in your limbs. A visual aura may or may not happen at the same time.
3. Dysphasic aura: This is a less common type. It includes verbal and language changes, like mumbling or slurred speech.

Is a migraine aura serious?

Although uncomfortable, a migraine aura isn’t dangerous. But it can mimic symptoms of other serious conditions, like a stroke. It’s important to seek medical care if you think something suspicious is going on. Also, frequent migraine auras do slightly increase the risk of stroke, so it’s important to establish care if you get them often.

What causes a migraine aura?

A disruption of electrical activity in your brain causes a migraine aura. This is known as cortical spreading depression. It’s like a wave that moves across your brain. The wave interrupts normal functioning, causing symptoms of an aura. The exact reason why this happens is unknown.

What triggers migraines with aura?

The same factors that cause a migraine typically trigger a migraine aura. Some of the most common include:

• Bright lights
• Different types of foods
• Certain medications you take
• Hormonal changes
• Sleep disturbances
• Stress

How is a migraine aura treated?

If you notice a migraine aura or other migraine warning signs, stop whatever you’re doing as quickly as possible. Find a dark, quiet room and rest, if you can. This could ease discomfort.

Within the first 15 minutes of aura symptoms, you’ll want to take a dose of medication that your healthcare provider approves. This could include:

• Pain relievers: Prescription or over-the-counter pain medications — like acetaminophen, ibuprofen or aspirin. Children shouldn’t take aspirin without a provider’s approval.
• Triptans: These block pain pathways in your brain. Triptans come as pills, injections or nasal sprays.
• Antinausea drugs: When a migraine happens with symptoms like nausea and vomiting, medications like metoclopramide, chlorpromazine and prochlorperazine may help.
• Magnesium: This supplement may break a visual aura and reduce pain.

How long does a migraine aura last?

In most cases, migraine aura episodes usually last between five and 60 minutes. Symptoms typically happen gradually.

Can a migraine aura be prevented?

While you can’t prevent a migraine aura altogether, there are certain things you can do to reduce the length, severity and frequency of attacks. Your healthcare provider might recommend:

• Antidepressants: Amitriptyline or venlafaxine may prevent migraines.
• Antiseizure drugs: Topiramate and valproate may reduce migraine frequency in many cases.
• Blood pressure-lowering medications: Calcium channel blockers like verapamil may prevent migraine aura. Your provider may also prescribe beta-blockers like atenolol, metoprolol, nadolol or propranolol.
• Botulinum toxin injections: Injections every three months may prevent migraines.
• Calcitonin gene-related peptide (CGRP) antagonists: These come in an infusion, injection or a pill form. Atogepant, eptinezumab, fremanezumab, galcanezumab, erenumab or rimegepant may prevent symptoms.
• Nutritional supplements like CoQ10 and riboflavin: Be sure to get your provider’s approval before starting a new supplement.

Your provider may recommend making a few lifestyle adjustments to lower your risk of common triggers. These could include:

• Following good sleep hygiene
• Making sure you stay hydrated and eat balanced meals throughout the day
• Decreasing stress

It may be challenging to make changes on your own, but you can work closely with your provider. They may have tips to make these adjustments easier for you.

Your provider may also suggest keeping a headache diary to learn more about possible triggers of your symptoms. You can keep track of what you were doing before the aura started, what you ate that day and how you felt. These notes may help you narrow down common things that cause symptoms to happen. You can take steps to avoid triggers to reduce your risk of future migraines.

When should a migraine aura be treated by a healthcare provider?

Migraine aura symptoms can look and feel similar to symptoms of other, more serious illnesses. Be on the lookout for symptoms that could be a warning sign of something more serious, like confusion, a loss of consciousness or weakness on one side of your body, among others.

What should I do if I have persistent migraine auras?

Most migraine auras last an hour or less. But you may have continuous migraine auras that last more than 60 minutes or up to a week or longer. Even though these are rare, they may affect you. Be sure to contact your healthcare provider right away if this is the case. Your provider will run tests to ensure that your symptoms aren’t due to more serious conditions.