What are migraine auras?
The aura stage of a migraine episode usually lasts for less than an hour. Common symptoms include tunnel vision, seeing stars, and tingling sensations in the hands or feet.
Although migraine and migraine auras can be debilitating, these headaches are not physically harmful, and people can usually manage their symptoms with medical and home treatments.
Read on to learn more about the types of migraine with aura and the available treatment options.
What is a migraine aura?
A migraine aura can sometimes last up to 60 minutes.
Migraine headaches are characterized by symptoms such as severe throbbing or pulsing head pain, sensitivity to light, sound, and smells, and nausea.
Of those who experience migraine headaches, 25–30% experience additional aura symptoms. Some people describe a migraine aura as a "warning sign," as its symptoms often develop before a headache.
Migraine aura symptoms usually appear over a 5–20 minute period and tend to last for up to 60 minutes.
Auras can take on one of three main forms: visual disturbances, physical sensations, and speech or language difficulties. We cover these in more detail in the following sections.
Some examples of visual changes associated with migraine aura include seeing:
- blind spots, called scotomas
- colored spots
- flashes of light
- stars or sparkles of light
- zigzag lines
- tunnel vision
These often start in the center of a person's field of vision before moving outward. People may also experience temporary vision loss or blindness during a migraine episode.
Physical sensation auras
For some people, auras involve physical sensations, such as tingling, numbness, and dizziness. These sensations may start on one side of the body before spreading slowly to other areas.
Physical aura sensations can include:
- pins and needles in the arms and legs
- numbness or tingling sensations
- vertigo (spinning dizziness)
- muscle weakness on one side
Speech or language difficulty auras
During a migraine episode, some people may find it difficult to speak or communicate with others. They may struggle to find the right words to use, or they may mumble or slur their speech.
Along with other sensations, migraine aura may also cause:
- memory changes
- feelings of fear
- rarely, partial paralysis or fainting
Types of migraine with aura
Migraine with aura is fairly common, and anyone with migraine can experience auras. However, some subtypes of migraine are particularly likely to involve auras.
Specialists have previously referred to migraine with aura as classic migraine, focal migraine, aphasic migraine, and complicated migraine.
Other, rare types of migraine that cause auras include:
This is a rare type of migraine that involves temporary weakness or paralysis on one side of the body. Other symptoms include pins and needles and numbness.
The weakness typically goes away within 24 hours, but it may last for several days.
According to the National Organization for Rare Diseases, researchers do not know the true prevalence of hemiplegic migraine. However, some research suggests that it affects around 1 in 10,000 people.
Migraine with brainstem aura
Migraine with brainstem aura, formerly known as basilar-type migraine, is rare. In fact, a 2006 study from Denmark indicates that it occurs in approximately 10% of people who experience migraine with aura.
The most common symptoms appear to be:
The researchers conclude that migraine with brainstem aura may occasionally happen to anyone who experiences migraine with aura.
Retinal migraine is another rare subtype of migraine aura. It affects vision in one eye only. It may cause temporary blindness or the appearance of flickering lights in that eye.
Around 1 in 200 people who experience migraine will experience retinal migraine. Most people who develop it are under 40. A personal history of any type of migraine and a family history of retinal migraine both increase the risk of experiencing retinal migraine.
Causes and risk factors
Medical professionals do not fully understand the exact cause of migraine.
Migraine with aura may occur when a wave of electrical activity moves across the visual cortex of the brain, which is the part that processes visual signals.
Triggers for migraine with aura include:
- alcohol consumption, especially wine
- caffeine consumption
- exposure to bright lights or strong sun
- food and food additives, such as aged cheeses, processed foods, and monosodium glutamate
- hormonal fluctuations in females (due to pregnancy, menstruation, or oral contraceptives, for example)
- intense physical activity or overexertion
- lack of sleep or too much sleep
- medications, such as the use of oral contraceptives or vasodilators for high blood pressure
- strong smells, such as that of smoke, perfume, or gasoline
- weather changes or barometric pressure changes
Factors that increase the risk of developing migraine, including migraine with aura, include:
- Sex: Females are two to three times more likely than males to experience migraine. It affects around 1 in 5 females.
- Age: This condition is most common in those ages 18–44.
- Family history: Around 90% of people with migraine have a family history of the condition.
Treatments and remedies
The treatment options for migraine with aura are similar to those for other types of migraine.
Treatment depends on the frequency and severity of a person's symptoms. Some options include:
Anti-inflammatory pain relievers may help treat migraine with aura.
The following over-the-counter (OTC) and prescription medicines can help treat migraine with aura:
- anti-inflammatory pain relievers, such as aspirin or ibuprofen (Advil, Motrin IB)
- migraine relief medications, such as Excedrin Migraine
- antinausea medicines, to reduce nausea and vomiting
- codeine medications or other opioids
- dihydroergotamines, in the form of a nasal spray or injection
- triptans, such as sumatriptan (Imitrex, Tosymra) or rizatriptan (Maxalt), to block the brain's pain signals
People who experience frequent or severe migraine headaches may benefit from preventive medications. These include:
- amitriptyline, which is a tricyclic antidepressant, or other antidepressants
- antiseizure drugs
- blood pressure medications, such as beta-blockers or calcium channel blockers
- Botox injections
Some medical devices may help reduce migraine pain by stimulating the brain in specific ways. These include:
Single pulse transcranial magnetic stimulation
These devices use pulses of magnetic energy. People must place them on the head for a few moments to see results.
Some research indicates that these devices can reduce the severity or frequency, or both, of migraine episodes. They are not suitable for everyone, however, and they are only available with a prescription.
In 2014, the Food and Drug Administration (FDA) approved the Cefaly device for migraine prevention. Individuals can wear the headband for 20 minutes per day.
Early research indicates that it shows promise in migraine treatment for some people.
Lifestyle changes and home remedies
Home remedies may help alleviate some migraine symptoms, while lifestyle changes can prevent onset.
To treat a migraine using home remedies:
- Take a nap when symptoms first appear.
- Lie down in a quiet, cool, dark room.
- Place a cool compress or ice pack on the forehead or back of the neck.
Lifestyle changes that may help prevent migraine episodes include:
- practicing stress reduction techniques, including yoga, deep breathing exercises, and progressive muscle relaxation exercises
- sticking to a consistent sleep routine, with the same bedtime and wake time every day
- eating a balanced diet that is low in processed foods and food additives
- drinking plenty of water and limiting or avoiding caffeine and alcohol
- avoiding migraine triggers, where possible, or using preventative medicines before triggering events (such as menstruation or weather changes)
For severe or recurrent migraine episodes, it is usually most effective to use medical treatments alongside home care strategies.
When to see a doctor
A person can talk to their doctor if migraine with aura does not completely resolve with time.
People who experience symptoms of migraine with aura should see their doctor as soon as possible.
People should also see a doctor if the symptoms:
- have an immediate onset
- last for longer than an hour
- only occur in one eye
- do not completely resolve with time
In these cases, a doctor should perform tests to rule out more serious conditions, such as a stroke or a retinal tear.
Migraine with aura can be uncomfortable and debilitating, but it is not life threatening.
Trying home care strategies and taking OTC medications can help most people manage their symptoms until the headache or episode subsides.
Those who experience recurrent or severe migraine headaches may require prescription medications or medical devices to manage their symptoms and prevent future episodes.