Table Of Content

A migraine aura may present as visual disturbances, often followed by a headache. Other symptoms may include tingling sensations or numbness in the face or limbs and difficulty speaking or understanding speech.

The American Migraine Foundation estimates that between 25% and 30% of people with migraine experience aura.

Because an aura can begin before a migraine attack starts, it can often be a warning sign that one is coming. Migraine aura can also occur at the same time as head pain.

Aura is not the same as a prodrome, which is a pre-migraine. An aura is a set of neurological symptoms that accompany a migraine episode. A prodrome is a set of symptoms that occur prior to head pain, such as fatigue, yawning, food cravings, nausea, irritability, neck pain.

Visual symptoms

Visual aura is the most common type of aura. Some symptoms you may experience during a visual aura include:

Sensory symptoms

Aura can also be a change in sensation. These symptoms can occur with or without a visual aura.

The main symptoms of a sensory aura are feelings of numbness or tingling, or a “pins and needles” sensation.

This tingling sensation may begin in one arm and travel upward. This feeling can also occur on one side of your face, lips, or tongue.

Speech and language symptoms

Disturbances in speech and language are less common aura symptoms. Symptoms may include:

  • slurred speech
  • mumbling
  • not being able to form the right words

Preheadache signs and symptoms

Pre-migraine, also called prodrome, is the earliest of four stages of a migraine attack. This stage happens before an aura and may occur several hours to several days before a migraine attack begins.

Recognizing the symptoms of pre-migraine may help individuals avoid triggers and prevent an attack. Pre-migraine symptoms may be different for individuals and may include:

  • constipation or diarrhea
  • depression
  • insomnia
  • irritability
  • light and sound sensitivity
  • mood changes
  • nausea
  • neck and shoulder stiffness
  • trouble focusing
  • tiredness

It’s possible for an aura to occur without a migraine attack. This is called silent migraine. Although the migraine pain doesn’t occur, the aura symptoms themselves can still be disruptive to daily activities.

Ocular migraine, a type of migraine attack characterized by visual symptoms, can sometimes occur without pain. Migraine with aura and retinal migraine are sometimes considered types of ocular migraine.

Migraine attacks that occur without pain may sometimes be diagnosed as transient ischemic attacks (TIAs) or seizures due to their similar symptoms.

It’s not well understood what exactly causes an aura. It’s believed to be caused by a wave of electrical activity that spreads across the cerebral cortex of the brain.

This wave is then followed by a prolonged suppression of nerve cell activity. This can lead to various changes, like changes in blood flow, which may lead to migraine symptoms.

It’s also possible that an aura may be triggered by the same things that can trigger migraine attacks without aura. These can include:

When aura symptoms begin, it can be helpful to move into a quiet, dark room and close your eyes.

Placing a cold compress on your forehead or the back of your neck may also help ease ensuing migraine pain.

Like other types of migraine, treating migraine with aura involves a combination of medications. These include medications for both prevention and relief of symptoms.

Preventive medications that may stop migraine attacks from occurring include:

Medications for symptom relief help decrease the severity of an oncoming migraine attack. They’re typically taken as soon as the symptoms of an aura or prodrome begin.

Examples of some of these medications are:

Other alternative methods of treating migraine are also being investigated. These include things like biofeedback, acupuncture, and relaxation techniques.

Migraine with aura is a clinical diagnosis. This means the condition is generally diagnosed by a doctor, usually a neurologist, by reviewing your medical history and a detailed list and description of your symptoms. The doctor will also perform a physical examination.

The International Classification of Headache Disorders, 3rd edition (ICHD-3), includes guidelines to help diagnose migraine with aura. Individuals must have at least two migraine attacks that include these criteria:

  • Having one or more aura symptoms in these categories:
    • Visual or retinal: symptoms that affect sight
    • Sensory: symptoms that affect the senses
    • Motor: symptoms that affect movement
    • Speech or language: symptoms that affect words and speech
  • having at least three of the these six characteristics:
    • one aura symptom or more that spreads gradually over more than 5 minutes
    • two or more symptoms together, one after the other
    • one or more unilateral aura symptoms
    • one or more positive aura symptoms
    • aura symptom(s) that last 5 to 60 minutes
    • aura along with or followed by headache within 60 minutes
  • having no other diagnosis that could cause these symptoms

Since there’s no definitive test for migraine with aura, neuroimaging tests like MRI or CT scans may not be necessary for most people. But neuroimaging may be recommended if an individual has other symptoms like:

  • head pain that does not respond to treatment
  • changes in number, type, or severity of headaches
  • new neurologic symptoms
  • sudden, severe headache
  • new headaches in individuals over 50 years old or in people with HIV or cancer
  • signs or symptoms of meningitis like double vision, nausea and vomiting, and dizziness
  • signs of stroke, like:
    • numbness
    • weakness in face
    • one-sided weakness especially in arm or leg
    • sudden onset of confusion, difficulty speaking or understanding speech
    • difficulty walking
    • dizziness or loss of balance
    • loss of vision or difficulty seeing from one or both eye

The symptoms of an aura can be similar to more serious conditions, like a stroke or seizure. If you haven’t experienced migraine with aura before and have numbness on one side of your body, trouble with your speech, or vision changes, seek immediate medical attention.

Migraine with aura can be treated with a combination of medications. Preventive medications may stop migraine symptoms from occurring, while other medications can help ease acute symptoms when they happen.