What to Know About Migraine Auras, the “Warning Stage” Before a Migraine
Having a migraine is associated with intense pain, but there are other symptoms that can come along with these headaches. One of the more common ones? Migraine aura.
Migraine aura is experienced by up to 30% of people who have migraines, according to the Cleveland Clinic. And, of those, the majority of people have a visual migraine aura.
But what is migraine aura and how can you tell if you’ve experienced it? Here’s what you need to know.
What is migraine aura?
Migraine aura, also known as migraine with aura or a classic migraine, is a recurring headache that happens after or the same time as sensory disturbances called aura, according to the Mayo Clinic.
Auras can include flashes of light, blind spots, and other vision changes, or tingling in your hands or face.
“We don't know why some [migraine patients] experience aura and some don't,” says Amit Sachdev, M.D., director of the division of neuromuscular medicine at Michigan State University.
Not all migraine auras happen with a painful headache, though. “Migraine aura without headache often occurs later in life, and is sometimes mistaken for a sign of a stroke,” says Andrew Charles, M.D., director of the UCLA Goldberg Migraine Program.
Types of migraine auras
There are three main types of migraine auras, per the Cleveland Clinic:
Visual aura. This is the most common type of migraine aura and causes temporary visual changes, like flashing lights, blind spots, or zigzags.
Sensorimotor aura. This form of aura causes sensory or motor disturbances like tingling, numbness, or weakness. People with sensorimotor aura may also have visual aura.
Dysphasic aura. This is the most rare form of migraine aura. It can cause verbal and language issues like mumbling or slurred speech. “The most common language aura is difficulty finding words, although in some cases there can be jumbling of words or nonsensical speech,” Dr. Charles says.
How is migraine aura diagnosed?
Migraine aura is usually a “diagnosis of exclusion,” says Clifford Segil, D.O., a neurologist at Providence Saint John’s Health Center in Santa Monica, Calif., so doctors will usually want to try to rule out other health conditions before diagnosis you with this. “We want to make sure there’ nothing sinister going on,” he adds.
That may mean having a few tests to rule out other conditions, like a transient ischemic attack (TIA), the Mayo Clinic says. Those may include an eye exam to rule out eye issues (if your aura is visual), a CT scan to look at your brain, and an MRI to also look at your brain.
Symptoms of migraine aura
Symptoms can vary based on the type of migraine aura you experience. However, the Cleveland Clinic says that visual migraine aura can cause the following symptoms:
Flashing lights
Brightly colored spots
Zig-zag lines
Foggy vision
Blind spots
The sensation that you’re looking at objects through water or heat waves
“These visual changes are often transient,” Dr. Segil says. Meaning, they only last for a short period of time. “It may look like a kaleidoscope or a tear in the vision,” he adds.
Other migraine aura symptoms, per the Mayo Clinic, can include:
Tingling in one hand or on one side of your face that may spread slowly along a limb
Weakness
Trouble speaking
Slurred speech
Migraine aura treatment
Treatment for migraine aura is basically the same as treatment for a migraine, says Medhat Mikhael, M.D., pain management specialist and medical director of the non-operative program at the Spine Health Center at MemorialCare Orange Coast Medical Center in Fountain Valley, Calif.
“People get the aura before the migraine comes and it becomes a sign that the migraine is coming in certain patients,” he says. “The best thing to do is to use the same abortive measures and medications you use for migraine.”
Dr. Sachdev agrees. “If you have a predictable pattern of headache attack, then you will want to initiate your headache abortive plan at the first sign of the aura,” he says. “Usually this includes medication, as the aura often portends a bad headache to come.”
Treatments can include using things like OTC pain relievers and triptans (which block pain pathways in the brain). Preventive treatments like antidepressants, anti-seizure medications, and Botox injections may also help prevent auras and migraines from happening in the first place, the Mayo Clinic says.
Keep in mind, per Dr. Charles, that “at this point, we don't have any acute treatments that can reliably stop an aura once it starts.”
Still, “if you take the medication to treat the migraine, the aura should lesson and become much more short-lived,” Dr. Mikhael says.
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