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Migraine headaches can be painful and debilitating. If you experience migraine attacks, you may also experience auras. These can occur before a migraine attack and involve sensory changes. These can include seeing sparks, zigzags, or bright dots or experiencing numbness or tingling sensations in the body.
In this article, we’ll explore the different types of migraine with aura, the symptoms they cause, and ways to prevent and treat them.
There are several different categories of migraines with aura, including:
A migraine with brainstem aura is an aura connected with a migraine headache consisting of head pain in the back and on both sides. Warning signs that you have an MBA can include slurred speech, dizziness, and loss of balance. Researchers have found that MBAs are more common among adolescent girls.
With a hemiplegic migraine, people may experience temporary weakness on one side of their body, along with auras like changes in vision or speech. Retinal migraine, also known as an ophthalmic migraine, can cause vision loss for 10 to 20 minutes.
Some people may experience migraine without aura. With this type of migraine attack, you don’t experience any sensory disturbances. Instead, one might experience symptoms during what’s called the premonitory phase before the migraine attack. These symptoms may include food cravings, constipation, fatigue, and sensitivity to light or sound prior. A moderate to severe migraine headache then follows, accompanied by pain on one side of the head or throbbing pain. In a postdrome phase — sometimes called a migraine hangover — you may feel depressed and fatigued and have difficulty concentrating and comprehending.
A migraine without aura is much more common than a migraine with aura. In fact, approximately 70 percent to 75 percent of people get migraines without aura.
When you experience a migraine with aura, you can have symptoms in the center of your field of vision that can spread to the sides. These symptoms include zigzag lines, bright spots, or flashing lights. You may also lose part of your vision or experience a blind spot, a condition called scotoma. The blind spots can resemble simple geometric designs. Some visual auras resemble a shimmering spot or star. Other symptoms include muscle weakness, difficulty speaking, and a tingling in one hand or on one side of the face.
Some of the symptoms of a migraine with aura could be similar to people with transient ischemic attacks or epilepsy, which brings neurological symptoms like unpredictable seizures.
A member of MyMigraineTeam described multiple phases of auras, which presented with different sensory changes. “Apparently I am in a new mode, which is giving me new visual auras different from anything I have ever had before,” she wrote. “The newest one was a small spot missing in the center of my vision, making the first two letters of words disappear. Luckily, my husband guessed migraine aura, which calmed me quickly. It lasted 10 minutes, then was followed by another aura of bright wavy lines on the outside of my left eye, which lasted 15 minutes. This was followed by a full-blown migraine encasing my entire head and both eyes.”
Another member noted that the frequency of their migraines with aura varied from two to three times per month to every one to two months. “Today was hard,” they said. “At around 12:30 p.m. I started getting the usual visual aura that comes with my migraines. My visual auras affect a big portion of my vision so doing day-to-day things is difficult (because I can’t see).”
Some visual auras can be colorful and appear like hallucinations. People living with migraine sometimes find it difficult to describe their aura sensations. “I had a particularly nasty migraine this morning, but I also experienced visuals during it,” one member shared. “I won’t call them hallucinations or auras as they weren’t. They were black-and-white pictures, but some areas were colored with one single color. In the first visual it was bright pink, and in the second visual, it was bright blue, and the colors hurt my eyes!”
Visual auras are like an electrical or chemical wave in the brain. Some members report experiencing more sensitive hearing during a visual aura. “If I don’t wake up with a migraine, then before it comes on I feel really achy and sluggish,” a member shared. “I also go blind for about 10-15 seconds, but my hearing is amplified at the same time.”
Sometimes, the symptoms that accompany an aura can be so intense, a person may think they’re having a more serious problem, like a stroke. “I'm curious to know if anyone else has had Alice in Wonderland syndrome as a visual aura?” one member asked. “It’s intense, and I honestly thought I was having a stroke the first time.”
If you feel the symptoms of a migraine attack that includes visual auras, consult your physician right away. They’ll examine you to make sure you’re not having a stroke or experiencing a retinal tear instead of a migraine with aura. You may need to see a neurologist, who will consider your medical history when diagnosing a migraine. The doctor may perform an eye exam and an MRI or CT scan.
Scientists don’t know exactly what causes migraines. However, severe headaches with an aura can result from:
In addition, migraines run in families. It’s possible that even a change in weather can bring auras. One member wrote, “Ugh, more storms coming our way. Feeling the aura.”
Another member reflected on how certain behaviors and stress cause migraines. Neurology and the nervous system do play a role in bringing on migraines. “Plans were all mixed up today,” they wrote. “Everything I planned for didn’t happen. I feel guilty I didn’t do certain things, and I’m frustrated by others’ actions. All these things always cause stress, which in turn causes headaches and sometimes migraines.”
There are several treatments available for migraine with aura. Some are the same as those prescribed for migraine without aura.
Some people benefit from taking over-the-counter remedies, such as aspirin (Bayer) and ibuprofen (Advil), if they’re feeling aura symptoms or a migraine headache.
Prescription drugs for treating migraine include sumatriptan (sold as Imitrex) and rizatriptan (Maxalt). These drugs can block brain pathways that cause pain. Your doctor also may prescribe opioid medications that contain codeine.
Other medications include dihydroergotamine — such as Migranal, available as a nasal spray, and D.H.E. 45, available as an injection. Dihydroergotamine can induce vomiting and nausea, which are migraine symptoms. Anti-nausea drugs like metoclopramide (Reglan) or prochlorperazine (such as Compro) can help with these symptoms.
Transcranial magnetic stimulation is an acute treatment for migraine. It involves applying an electromagnetic coil to the forehead that delivers a series of magnetic pulses to stimulate nerve cells in the brain.
Doctors may suggest treatments as a preventive measure. Among them are:
Finally, onabotulinumtoxinA (Botox) injections can stop some people from getting migraines. One member wrote, “I started Botox five years ago. It was amazing. I went almost three years with barely any migraines, and now just this year, mine started back up again. But I still think the Botox is helping.”
By joining a community of more than 77,000 members of MyMigraineTeam, you can share your experiences with people living with migraines with or without aura. Members support each other and share insights on how they have learned to manage migraine symptoms.
Have you experienced a migraine with aura? What were your aura symptoms? What treatments did you receive? Share your experiences in the comments below or on MyMigraineTeam.
Evelyn O. Berman, M.D. is a neurology and pediatric specialist and treats disorders of the brain in children. Review provided by VeriMed Healthcare Network. Learn more about her here.
Brian T. Horowitz is a graduate of Hofstra University in New York with a B.A. in English. He is a longtime health and technology journalist. Learn more about him here.
