Migraine Aura

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 are the different types of migraine aura?

There are three main types of migraine auras:

1. Visual aura. This common type of migraine aura is characterized by temporary changes in your vision, such as flashing lights or zigzags.
2. Sensorimotor aura. Sensory or motor disturbances may include tingling, numbness or weakness, which may or may not be accompanied by visual aura.
3. Dysphasic aura. This is the least common type of migraine aura. It includes verbal and language symptoms like mumbling or slurred speech.

How common is a migraine aura?

Only 25% to 30% of people with migraine headaches experience migraine aura. Of that population, approximately:

• 90% to 99% of people develop visual aura.
• 36% of people develop sensory aura.
• 10% of people develop dysphasic aura.

What does visual migraine aura look like?

People who experience visual migraine aura may notice a variety of disturbances in their field of vision. Visual migraine aura symptoms may include:

• Flashing lights.
• Brightly colored spots.
• Zigzag lines.
• Foggy vision.
• Blind spots.
• The sensation that you’re looking at objects through water or heat waves.

Is migraine aura serious?

Although uncomfortable, migraine aura isn’t dangerous. However, it can mimic symptoms of other serious conditions, such as stroke. Therefore, it’s important to seek medical care if you think something suspicious is going on.

What causes migraine aura?

The exact causes of migraine aura are unknown. However, research indicates that the condition may be due to an electrical wave that moves across the visual cortex, resulting in visual changes.

What triggers migraine aura?

Migraine aura is typically triggered by the same factors that cause migraine without aura. Common causes include:

• Bright lights.
• Certain foods or medications.
• Stress.
• Sleep disturbances.
• Periods.

How is migraine aura diagnosed?

To rule out more serious conditions, such as a transient ischemic attack (TIA) 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 (computed tomography) scan of your head. This scan takes detailed images of your brain.
• Magnetic resonance imaging (MRI). This test uses magnets and radio waves to capture images of your tissues, organs and structures inside of your body.

How do I stop migraine aura?

Migraine aura treatment is focused on easing symptoms. Your healthcare provider may recommend a number of medications, including:

• Pain relievers. Prescription or over-the-counter pain medications — such as acetaminophen, ibuprofen or aspirin — can alleviate migraine aura and associated pain.
• Triptans. Sumatriptan and rizatriptan block pain pathways in the brain. These medications may be prescribed as pills, injections or nasal spray.
• Dihydroergotamine nasal spray or dihydroergotamine injection. These medications can be taken at the onset of a migraine attack in an effort to lessen symptoms.
• Opioids. These drugs may be recommended for people who can’t take triptans or dihydroergotamines. Because opioids are highly addictive, this treatment should only be considered when all other options have failed.
• Antinausea drugs. When migraine aura is accompanied by nausea and vomiting, medications like metoclopramide, chlorpromazine or prochlorperazine can ease these symptoms.
• Magnesium. This supplement can break visual aura and reduce pain.

Can I prevent migraine aura?

While migraine aura can’t be prevented altogether, there are certain things you can do to reduce the length, severity and frequency of attacks. If you experience severe migraines that don’t respond well to treatment, your healthcare provider might recommend:

• Nutritional supplements like magnesium, CoQ10 and riboflavin. Be sure to take these according to the recommendations of your healthcare provider.
• Medications to lower your blood pressure. Calcium channel blockers like verapamil can help prevent migraine aura. Your healthcare provider may also prescribe beta blockers, such as timolol, propranolol or metoprolol tartrate.
• Antiseizure drugs. Topiramate and valproate can reduce migraine frequency in many cases. However, they can cause undesirable side effects, such as nausea, dizziness and weight changes.
• Antidepressants. Amitriptyline or other antidepressants may help prevent migraines in some people.
• Calcitonin gene-related peptide (CGRP) monoclonal antibodies. These are newer, FDA-approved injectable drugs that are used to treat migraines. They are given monthly to help prevent symptoms.
• Botox® injections. In some people, Botox injections given every 12 weeks can help prevent migraines.

How long does migraine aura last?

In most cases, migraine aura symptoms start gradually. Episodes usually last between 20 and 60 minutes.

How can I manage a migraine aura episode?

If you notice migraine aura or other migraine warning signs, stop whatever you’re doing as quickly as possible. Take any medications recommended by your healthcare provider. Find a dark, quiet room and sleep if you’re able.

When should I see my healthcare provider?

Migraine aura symptoms can be similar to symptoms of other, more serious illnesses. Therefore, you should contact your healthcare provider immediately if warning signs occur.

Can you experience migraine aura without the headache?

Yes. Some people experience silent migraine auras. Treating this condition can be difficult since most medications take longer to work than the aura’s duration. Still, taking pain medication at the first sign of aura may reduce the risk of pain, nausea and sensitivity to light or loud noises.

What causes migraine aura without pain?

The causes of migraine aura without pain or headache aren’t fully understood. However, you can learn more about specific triggers by keeping a journal or diary. Keep a record of when your episodes occurred, how long each one lasted and what the symptoms were like. In some cases, this can help you figure out what triggers your migraine auras.

What should I do if I have persistent migraine aura?

Most migraine aura last an hour or less. However, some people may experience continuous migraine auras that last a week or longer. If this happens to you, be sure to contact your healthcare provider right away. They’ll run tests to ensure that your symptoms aren’t due to other, more serious conditions.

Can migraine aura increase during pregnancy?

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

A note from Cleveland Clinic
Migraine aura isn’t 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 isn’t related to other, more troubling health problems.