Not everyone suffers from a typical migraine. Migraine is derived from the Greek work “hemicranias,” meaning half-headed. Half-headed refers to the stabbing pain that is usually experienced during a migraine on one side of the head. Migraine is one of the most commonly occurring neurological conditions throughout the developed world and is known to be more prevalent than epilepsy, diabetes and asthma. There are different types of migraine and the symptoms vary accordingly. Migraine with aura is the more common type of migraine and it is expected that nearly 20% of all migraine sufferers have this type of migraine. Commonly referred to simply as aura, migraine with aura gets its name due to the aura that comes on as a warning sign of the impending migraine headache. Often, an aura before the actual migraine attack is characterized by visual disturbances and symptoms can include flashes of light or blind spots, light patterns or even distorted vision. These may occur up to half-an-hour before the onset of the migraine pain. Studies suggest that if the aura is treated before the migraine sets in, it can actually halt the migraine headache before the actual pain begins, and efficiently ending the migraine before it even starts.

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What is Migraine with Aura?

What is Migraine with Aura?

A migraine aura is usually a sure shot sign of an impending migraine attack. An aura is a visual arc of shining shapes or spots that can start in a small area in your central vision field and continue to expand peripherally. This expansion in movement across the visual field happens due to a cortical spreading depression (CSD). According to doctors, "a wave of electrically excitable neurons and their surrounding cells depolarizing is known as a CSD." Cells usually tend to reverse their polarity, that is, normally negatively charged cells become positively charged and vice versa. This leads to a period of suppressed neural activity. Auras can last for anywhere between 5 to 60 minutes, followed by a headache that is characteristic of a migraine.

Types of Auras in Migraine

It's not necessary that everyone who experiences an aura will go through the same symptoms. Nearly 86% of sufferers of migraine with aura feel visual symptoms. There are also some types of migraine auras that are not as common as visual auras. These are motor aura, sensory aura, and language aura. Let’s take a look at these lesser known migraine auras.

  • Motor aura results in paralysis or muscle weakness in a particular area or on one side of the body.
  • Sensory aura disturbs the other senses of the body, such as touch, smell and can lead to hearing impairment or disruption.
  • Language aura causes disruption in speech and language, leading to difficulty in speaking or finding the right words.
  • Retinal migraine can also lead to a lesser known type of aura, which is, a visual aura occurring only in one eye. A retinal migraine also does not necessarily lead to a headache after the aura as part of the migraine attack.
  • Symptoms originate from the brainstem in a brainstem aura and include vertigo, double vision, slurred speech, lower level of awareness or alertness.

Common Visual Signs & Symptoms During a Migraine Aura

For people who experience migraine with aura, it generally begins with temporary visual signs or disturbances. Some of the common visual disturbances and symptoms that occur at this stage include:

  • Blind spots, known as scotomas that can sometimes be outlined by geometric patterns.
  • Zigzag lines floating across your field of vision.
  • Shimmering spots.
  • Shimmering stars.
  • Changes in vision, sometimes leading to complete vision loss.
  • Flashes of light.
  • Dancing dots.
  • Colored spots.
  • Tunnel vision.
  • Distortions may occur in the shape and size of objects.
  • Heightened sensitivity to light.
  • Vibrating visual field.

Less Common Symptoms or Sensations During Migraine Aura include:

  • Sudden onset of fear or anxiety.
  • Nausea or other related abdominal symptoms.
  • Feeling of being separated from your body.
  • Feeling overheated.
  • State of being confused.
  • Reduced mental cognition.
  • Feeling like your limbs or teeth are growing.

Causes of Migraine with Aura

Till date, no researcher or scientist has been able to understand clearly what causes migraine or migraine with aura. While it is thought that several brain chemicals have a role to play in producing migraine with aura, there is no clear data or evidence to support this. According to one popular theory, a wave of nerve cell activity spreads across the brain, exciting the trigeminal nerve as it spreads. This process of excitation releases many neurotransmitters that lead to a change in the size of the blood vessels. This further releases more neurotransmitters, thus causing inflammation and pain.

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The aura in migraine is believed to be caused by the electrical wave moving across the brain. The wave affects the part of the brain that is responsible for processing signals from your senses. Thus, it creates disturbances with your senses.

As migraines tend to run in families, it is believed that people are genetically predisposed towards having a migraine. Migraine attacks generally start in childhood and worsen as a person reached adolescence. Migraines become less frequent after the age of 50.

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How to Diagnose Migraine with Aura?

Most physicians take the below factors as checklist for diagnosing migraine with aura. You need to meet all these criteria in order to be diagnosed with migraine aura. You need to have at least one aura symptom that spreads slowly for five minutes or more.

  • Two or more symptoms need to occur in succession.
  • Each individual migraine aura symptoms has to last between 5 to 60 minutes.
  • Migraine aura symptoms will be on one side of the body only.
  • Aura will be followed by the migraine headache within 60 minutes.

Steps to Stop a Migraine Aura

It is believed that if you treat the migraine during the stage of the aura, in some cases you will be able to successfully stop the headache before the migraine attack actually begins. Here we take a look at how we can make this possible.

Step 1: Whenever you start to notice aura symptoms coming on, you should stop everything you are doing and make an honest attempt to stop the oncoming migraine attack. The longer time you take to treat the aura symptoms, the likelier it will be that it will develop into a full-blown migraine headache.

Step 2: Lying down in a darkened room and gently massaging your head usually helps with the pain. Relieving the pressure in your scalp can also help the impending migraine. Try to do this under relaxing conditions.

Step 3: An alternative medicine therapy that can be used is biofeedback. At the first sign of aura, you should try biofeedback. This technique monitors and controls the biological responses of your body using your brain. According to MayoClinic.com, "electrodes attached to the skin can measure factors like skin temperature, brain waves and muscle tension." A biofeedback therapist can teach you how to relax the blood vessels or muscles in the brain to stop the migraine from setting in.

Step 4: Drinking a cup of coffee often helps stop a developing migraine, particularly when taken along with acetaminophen. Be mindful, however, that too much of caffeine consumption can also lead to withdrawal headaches.

Step 5: Take a general over-the-counter pain killer during the aura. Options range from aspirin, ibuprofen and acetaminophen. You need to take the pain reliever before the actual headache begins.

Step 6: Drink plenty of water to stay hydrated as hydration plays an important role when vomiting is part of aura symptoms.

Step 7: After consulting a doctor, you can try using some homeopathic remedies. Belladonna, Lachesis, Bryonia, Sepia, and Ignatia are some common homeopathic remedies for headache.

Step 8: Ask your doctor for a prescription of a triptan medication. Triptans are known to stop a migraine in progress also by constricting blood vessels. They can also be taken when the migraine aura begins. Triptans are not available over-the-counter, so you will need a prescription to buy these medications.

Step 9: Some herbs such as feverfew and butterbur are also known to be effective at preventing or stopping migraines. However, as with any medications, consume these only after consulting your doctor.

Please be mindful of the fact that overusing pain medications for migraine can lead to rebound headaches as well. So don't use these medications for more than two to three days in a row during a single week.

When to See a Doctor for Migraine with Aura

You should see a doctor if you experience these rare symptoms of migraine with aura such as temporary vision loss or paralysis on one side of the body. Your doctor will need to run some tests in order to rule out more serious conditions such as a retinal tear or a stroke. After ruling out these conditions, future migraines with aura do not warrant a visit to the doctor, unless your symptoms change.

The factors that trigger migraines are also known to trigger migraine with aura. These include stress, some foods, medications, bright lights, lack of sleep, menstruation etc. While no identified factors are known to increase the risk of migraines with aura, it is more common in people who have a genetic history of migraine.

Many studies have shown that people with migraine with aura are at an increased risk of suffering a stroke or cardiovascular diseases. This is especially true for women who smoke or take birth control pills.

Pramod Kerkar

Written, Edited or Reviewed By:

, MD,FFARCSI

Pain Assist Inc.

Last Modified On: March 10, 2018

This article does not provide medical advice. See disclaimer

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