Asger Hee Stjernholm, MSc

What Is Migraine With Aura?

You may have been diagnosed as having migraines with aura. But you might be thinking: “What even is aura? What are the symptoms? And what does this mean for my life moving forward?”

First up, if you have had this diagnosis, don’t worry. Whilst migraines are difficult to live with, they are not impossible. We’ll talk you through some great treatment ideas to better manage all your migraine with aura symptoms.

But let’s start right at the beginning…

What is migraine with aura?

‘Aura’ is the name given to the warning symptoms which sometimes occur just before a migraine headache sets in, or as it develops.

These symptoms could include visual disturbances, such as blind spots, flashing lights, zigzag lines and even vision loss. These disturbances tend to start in the center of the field of vision and spread out, sometimes developing and worsening over a time frame of 5 to 20 minutes.

Despite coming on gradually, these symptoms can still be highly alarming — especially the first time they are experienced. For some individuals, a migraine with aura will also cause physical issues and/or difficulty with speech. For example, it’s not uncommon for migraine with aura to bring about muscle weakness, or a ‘pins and needles’ sensation, on one side of the body. Combined with slurred speech or trouble communicating, it’s unsurprising that some migraine patients fear they are having a stroke. The vast majority of the time, though, this concern is unfounded — so stay calm!

In fact, one way to tell the difference between a migraine with aura and a stroke is that aura symptoms — whether visual, verbal or physical — will build up in severity, whereas a stroke will strike quickly and with little warning.

About a quarter of migraine patients will experience aura before all or some of their attacks. This means that even if you are someone who experiences migraine with aura, you might not suffer aura symptoms with every migraine. Equally, an aura isn’t always followed by an intense headache, or any headache at all.

This just goes to show how unpredictable living with migraines can be!

Other names for migraine with aura

You may hear migraine with aura described in a number of different ways, including:

  • Classic migraine
  • Classical migraine
  • Focal migraine
  • Ophthalmic migraine
  • Aphasic migraine
  • Migraine accompagnée
  • Complicated migraine

These terms are all just different ways of describing the same thing — migraine with aura.

How is migraine with aura different to other migraines?

There are lots of different types of migraines, such as retinal migraines — affecting just one eye — and menstrual migraines, which come on near the start of your period.

Many migraine types share the same symptoms, that is headache, nausea, and sensitivity to light or sound. People who have migraines with aura will experience these symptoms plus the visual, verbal and physical symptoms we spoke of earlier.

Subtypes of migraine with aura and their symptoms

Migraine aura symptoms vary from person to person. There are also some auras with characteristic symptoms, which are classified as subtypes.

One subtype is ‘migraine with brainstem aura’, also known as ‘basilar-type migraine’. Symptoms of this subtype of migraine with aura include vertigo (feeling as if things are moving when they are not), slurred speech, tinnitus (ringing in the ears) and double-vision. This subtype of migraine with aura is quite rare.

Another rare subtype is ‘hemiplegic migraine’, which involves temporary weakness on one side of the body. This can be especially concerning for sufferers, as these symptoms can appear similar to those of a stroke. However, the symptoms of hemiplegic migraine wear off when the aura is over.

Causes of migraine with aura

To be honest, no one really knows what causes migraine with aura.

The most widely accepted explanation is that migraine with aura is brought on by hyperactivity in the cortex, which produces waves of inflammation across the brain. You may hear of this referred to as cortical spreading depression (CSD).

But on a more basic level, migraine with aura may be triggered by lifestyle and external stimuli. Migraine triggers can be highly individual, and will vary from patient to patient — so if you haven’t started already, you should keep note of what you were doing, where you were and what was happening the last time you had a migraine attack.

Common migraine with aura triggers include alcohol, stress, and lack of sleep. But also changes in the season and even relaxing after stress can cause a migraine — in fact, “let-down stress” is the leading cause of migraine with aura!

Do I have migraine with aura?

A doctor can help diagnose your migraine type, but they will be mostly relying on you to tell them the symptoms you are experiencing. Therefore, it’s a good idea to really track and understand your migraine experience — whether with or without aura — to ensure you reach an accurate diagnosis.

So, let’s take a look at migraine with aura symptoms in detail:

Visual symptoms

As mentioned previously, symptoms of aura can include blind spots or colored spots in your field of vision. Some people see sparkles, stars, flashing lights or zigzag lines. Others may experience tunnel vision or even temporary blindness.

While this experience can be alarming at first, once you realize what is going on, you can take steps to treat your migraine and see it through. It is also reassuring to know that these symptoms will wear off — even if it doesn’t feel like it at the time!

Physical aura symptoms

It’s not unusual for migraine with aura to affect the rest of the body, too.

For some, this leads to a feeling or numbness or tingling in different limbs, perhaps with a sensation of ‘pins and needles’ in their arms and legs. These physical symptoms can sometimes feel like they are spreading too, moving from the hand to the arm, for example.

Others may feel weakness down an entire side of their body (as with hemiplegic migraine) or even dizziness and feeling of spinning (vertigo).

Very rarely migraine with aura sufferers can experience partial paralysis or fainting.

Mental and emotional symptoms

Of course, migraine with aura is never a pleasant experience. But during some attacks patients may feel unexplained — and quite sudden — fear, anxiety or confusion, leading to a state of panic. Changes in memory have also been reported.

If any of these mental or emotional symptoms happen to you, try to remind yourself it’s just the migraine you are experiencing — these unpleasant feelings will pass in time.

Migraine aura treatment and prognosis

Medical treatments (either over the counter or prescribed) are aimed at relieving the pain of migraine headaches or reducing the nausea and vomiting which can occur when you have a migraine, whether with or without aura.

There are also a number of preventative treatments available for those who suffer frequently from migraines. These can reduce the severity of attacks, make them shorter and cause them to occur less often. Another way to prevent migraines can be to identify and avoid the things which trigger them for you — perhaps certain foods.

If you’re seeking a more natural way to manage your migraines, there are a number of non-pharmaceutical treatments available to you. Some people find great relief from acupuncture.

Finally, if you suffer from migraines it is important to rest and give yourself proper time to recover — don’t jump up and try to start working again if your head is still throbbing! Some migraine sufferers also find that exercises which promote relaxation, like yoga, can help reduce their symptoms.

While there is no magic cure for migraine with aura, the symptoms can be managed successfully in most cases, either through treatment or prevention.

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