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Have you ever heard of or might have witnessed some disturbances before the onset of a migraine attack? Maybe some visual disturbances or other neurological symptoms? If yes, that is known as migraine aura. Keep reading to know more about what is a migraine aura and to understand migraine auras in great depth.
1. What is a Migraine?
A migraine is not just a regular headache but a neurological condition that produces excruciating throbbing pain or a pulsing sensation, usually affecting one side of the head.
It is a quite common disease, and about 12% of Americans experience migraines.
The intensity of a migraine attack differs from person to person. For some, migraine headaches may not become a hindrance to their daily life, while for others, migraine attacks can prevent them from going about their usual activities.
The duration of migraine episodes also varies as they can last for a few hours for some people, while other migraine sufferers might have to endure it for days.
2. Migraine Symptoms
Migraines usually have four stages: the prodrome stage, the aura stage, the attack, and finally, the post-drome stage. However, the good part is that not everyone who suffers from migraines progresses through all stages.
One or two days before a migraine, you may notice minor changes that indicate an upcoming migraine, such as:
- Mood changes
- Hunger pangs
- Stiffness in the neck
- Retention of fluid
Auras are reversible nervous system phenomena that can appear before or during a migraine attack. Visual disturbances are the most common, but other types of disorders can also occur.
We will elaborate on what is a migraine aura further in this article. For the time being, it would be sufficient to note that some of the migraine aura symptoms include:
- Seeing diverse shapes
- Experiencing flashing lights
- Seeing bright spots
- Loss of vision
- Tunnel vision
- Needles and pins a feeling in limbs
2.3 Attack (Headache)
The attack, which involves severe headache pain, begins on one side of your head and usually extends to the opposite side. It can be quite mild for some people, but the pain is agonizing for most.
A migraine headache phase can persist anywhere from 4 to 72 hours if left untreated.
You may encounter the following symptoms during a migraine:
- Throbbing or pulsing pain
- Light and sound sensitivity
- Vomiting and nausea
Also known as a migraine “hangover,” the postdrome stage lasts one or two days and affects around 80% of migraine sufferers.
During the post-drome phase, you may experience:
- A sudden head movement may also reactivate the discomfort for a brief period.
We shall be focusing on the aura phase of the migraine brain for the rest of the article. A migraine aura is a quite common phenomenon that we shall understand in detail.
3. What is a Migraine Aura?
As discussed above, a migraine aura is a group of symptoms that appear before or during a migraine attack. Auras usually start around an hour before the migraine attacks and linger for a maximum of 60 minutes.
Since a migraine aura occurs before the onset of a migraine attack, it is frequently considered a warning sign.
According to the American Migraine Foundation, between 25 to 30% of migraine sufferers experience migraine with aura. Migraine auras can create problems with your vision, physical sensations, and even your speech at times.
Now that it is clear to us what a migraine aura let us understand the symptoms of a migraine with aura in detail.
3.1 Symptoms of Migraine Auras
As mentioned before, a migraine aura can have varied symptoms. Migraine auras are of different types and based on the types, the aura symptoms have been widely classified into three categories: visual symptoms, sensory symptoms, and speech symptoms. There are some other symptoms too, which we shall look into.
Visual auras are the most common type of auras witnessed by those who experience migraine with aura.
You may experience the following visual disturbances while experiencing this typical aura:
- Partial loss of vision or blind spots called scotomas
- Seeing jagged bursts of flashing lights, stars, or bright spots in your field of vision
- Seeing zigzagging lines or geometric forms in your visual field
- Tunnel vision
It is also important to note that a visual aura symptom would typically begin in the center of a person’s range of vision and spread outward.
A migraine aura can also cause changes in sensation. These signs and symptoms can appear with or without the presence of a visual aura.
The sensory disturbances experienced by migraine sufferers include:
- Tingling sensations
- Needles and pins a feeling in limbs
These sensations may begin on one side of the body and then gradually move to other parts.
Speech and linguistic disturbances are less prevalent aura symptoms. The person experiencing this might face trouble speaking, and the following are some of the signs and symptoms to look out for:
- Speech that is slurred
- Struggle to find the correct words
Apart from the symptoms mentioned above, migraine aura can also cause a variety of other symptoms, including:
- Memory shifts
- Feeling of confusion
- Partial paralysis
3.2 Causes of Migraine Aura
While figuring out what is a migraine aura felt relatively simple, this is the part where we find ourselves in a fix.
The problem that arises here is that there is no recognized etiology for a migraine aura. While what causes a migraine aura isn’t completely understood, a wave of electrical activity that extends throughout the cerebral cortex is thought to be the cause.
This wave is then followed by a protracted period of nerve cell activity inhibition. This can cause a variety of alterations in your central nervous system and blood vessels, including changes in blood flow, which can trigger migraines.
If we put this into medical terms, it is Cortical Spreading Depression, a slow-moving wave of near-complete neuronal and glial depolarization that spreads across the cortex. Thus, Cortical Spreading Depression may play a role in the underlying pathophysiology of migraine aura, as well as an intrinsic brain activity that causes migraine headaches.
It’s also possible that the same things that trigger migraines in general, even migraines without aura, can cause an aura.
These can include the following migraine triggers:
- Anxiety or stress
- Sleep deprivation
- Skipping meals or eating infrequently
- Consumption of certain foods such as chocolate, aged cheeses, and preserved meats
- Caffeine or alcohol consumption
- Food additives
- Bright lights
- Strong odors
- Loud noise
- Hormone fluctuations, such as those seen during menstruation
- Excessive exercise
- Certain medications
- Weather changes
Genetics and family history also play a role in being the cause for migraine as around 90% of migraine sufferers have a family history of the disorder.
4. Types of Migraines: These may be accompanied by Migraine Auras
Auras are a typical symptom of migraine, and they can affect anyone who suffers from the condition. However, auras are more common in some migraine subtypes than others.
Migraine with aura is the most common type. Experts have previously classified it as a classic migraine, aphasic, focal, or complicated migraine.
Auras can also be caused by other, more uncommon kinds of migraine such as:
4.1 Hemiplegic Migraine
This is an uncommon kind of migraine in which one-half of the body experiences momentary weakness or even paralysis. Tingling, sensations of pricking, and numbness are other symptoms experienced during a hemiplegic migraine, which are also symptoms of migraine with aura.
Hemiplegic migraines can happen with or without a migraine headache. The weakness caused by this usually goes away in 24 hours, although it can last up to a week in some cases.
According to some studies, this type of migraine affects about 1 in 10,000 persons.
4.2 Migraine with Brainstem Aura
A migraine with brainstem aura, previously called basilar migraine, is rare. In this disorder, the aura symptoms originate in the brain stem.
Vertigo, a ringing sensation in the ears or tinnitus, double vision or diplopia, and speech difficulties are the most common symptoms.
According to the experts, migraine with brainstem aura can occasionally occur in anyone with migraine with aura. In fact, according to a 2006 study from Denmark, it affects about 10% of persons who suffer from migraine with aura.
4.3 Retinal Migraine
Another uncommon kind of migraine aura is retinal migraine. It solely impairs one eye’s vision. It could result in temporary blindness or the appearance of flickering lights in the affected eye.
Retinal migraine affects about one out of every 200 people who suffer from migraine. A personal history of migraines of any kind, as well as a family history of retinal migraines, both enhance the likelihood of developing retinal migraines.
4.4 Vestibular Migraine
A vestibular migraine is a neural system disorder characterized by the abrupt onset of vertigo, confusion, and problems with balance.
Many people who suffer from vestibular migraine have a history of migraine symptoms but may have never experienced a migraine headache before.
5. Can You Experience a Migraine Aura Without a Migraine Headache?
After gaining all this information, you might be wondering whether or not you can experience a migraine aura without a migraine headache. The answer to this question is yes.
Yes, you can experience a migraine aura without a migraine headache. Silent migraine is the name for this type of migraine.
Even though the thought of not suffering the severe pain of a migraine headache may seem like a relief, a silent migraine should be taken lightly as even if the migraine pain does not develop, the aura symptoms might still cause problems in daily life.
A good example of such a case would be ocular migraine, a form of migraine attack marked by visual symptoms that can occur without head pain. Types of ocular migraine can include migraine with aura and retinal migraine.
Because the symptoms are so similar, migraine attacks that don’t cause pain at a time can be mistaken for a Transient Ischemic Attack (TIA) or a seizure.
6. Treatment and Remedies for Migraine Auras
Now that you know what is a migraine aura, you might be wondering how you can avoid one.
The truth is that while migraine aura cannot be avoided entirely, you can take steps to lessen the length, severity, and frequency of episodes.
Treatment choices and remedies for migraines with aura are similar to those for other migraine types. They are determined by the intensity and frequency of a person’s symptoms. Among the possibilities are:
6.1 Lifestyle Changes
Whether it’s cluster headaches, tension headaches, or migraines, your lifestyle plays a significant role in reducing the frequency and severity of migraines and headaches.
The following are some simple lifestyle adjustments you can incorporate into your daily life that may help you prevent migraines and auras:
- Reduce stress
- Consistent sleep routine
- Consuming a balanced diet
- Avoiding certain foods that trigger migraines
- Drink more water
- Limit or eliminate coffee and alcohol
6.2 Home Remedies
While migraine headaches and auras can be extremely bothering, you might not always have to great lengths to treat them. Some quick and simple home remedies can prove beneficial most of the time.
Some migraine aura symptoms can be relieved with home remedies such as:
- As soon as the symptoms first arise, take a nap
- Move into a cool, quiet, and darkroom
- Apply a cool compress or ice pack to the back of the neck or the forehead.
When home remedies fail to work or are out of reach, you can always use medications to prevent or help relieve you of your migraine trouble.
Medications include medications for both preventive and abortive treatment of migraines and auras.
1. Preventive Medications
As the name suggests, preventive medications help reduce the chances of a migraine attack and even an aura. However, they should be used with precautions as most of them have severe side effects.
Some preventive medications that are known to be helpful include:
- Blood pressure medications: They are prescription drugs to help you lower your blood pressure. Verapamil is a calcium channel blocker that can help avoid migraine aura. Beta-blockers, such as timolol, propranolol, or metoprolol tartrate, may also be prescribed by your doctor.
- Antidepressants: Antidepressants are frequently used to prevent migraines. Amitriptyline has the most research backing it up as a migraine preventative. Nortriptyline is another option available for amitriptyline for those unable to take it. Antidepressants, however, have a large number of adverse effects. The risk of a withdrawal effect from antidepressants, in particular, should be kept in mind.
- Anti-seizure medications: Topiramate and valproate can help lessen migraine frequency in many circumstances. They can, however, induce unpleasant side effects such as nausea, dizziness, and weight gain.
- Calcitonin Gene-Related Peptide Inhibitors: During acute migraine and cluster headaches, Calcitonin Gene-Related Peptide levels in the jugular vein blood are high. Studies have shown that Calcitonin Gene-Related Peptide transcription is elevated in situations that resemble neurogenic inflammation. Thus the use of such inhibitors can help prevent migraines and head pain.
- Injections of Botox: Botox injections given every 12 weeks can help some people avoid migraines as Botox is thought to help with migraine headaches by blocking molecules called neurotransmitters, which transfer pain signals from the brain. Botox is a diversion from that path. It keeps the chemicals from reaching your head and neck’s nerve terminals.
2. Acute Treatment Medication
Medications for symptom relief can assist in lessening the severity of a migraine episode that is about to happen. They’re usually taken as soon as an aura symptom appears or when a migraine begins, and this practice is referred to as acute treatment of migraines.
The following are some medications involved in acute treatments:
- Pain relievers: Migraine aura and pain can be relieved by prescription or over-the-counter pain relievers, including acetaminophen, ibuprofen, or aspirin.
- Triptans: Sumatriptan and rizatriptan are pain relievers that work by blocking pain pathways in the brain. These drugs can be taken as tablets, injections, or nasal sprays.
- Dihydroergotamine injectable or dihydroergotamine nasal spray: These drugs can be given at the start of a migraine attack to help alleviate symptoms.
- Opioids: People who cannot take triptans or dihydroergotamines may benefit from these medications. Because opioids are highly addictive, they should only be used as a last resort after exhausting all other choices.
- Anti-nausea medications: Medications such as metoclopramide, chlorpromazine, or prochlorperazine can help with nausea and vomiting associated with migraine aura.
It is best to consult with a medical professional regarding your condition and symptoms for proper migraine treatment, as different types of headache disorders require a differential diagnosis. Avoiding such consultations would also put them at an increased risk of suffering from the side effects of these medications.
We hope that this article cleared your doubts as to what is a migraine aura and provided you with all the necessary information relating to it.
We tried to cover all topics starting from understanding migraine, followed by defining migraine aura, its symptoms and causes, and finally, the treatment and remedies. In between, we also answered some related questions that might have popped up in your mind related to what is a migraine aura.