Migraine with aura

• Migraine with a visual aura refers to a classic form of migraine accompanied by visual disturbances.
• An aura usually occurs before the migraine attack, although in some cases, you can also experience it during or after your migraine episode.
• Treatment for aura migraine is focused on symptom relief and prevention.

Migraine with aura is a classic form of migraine affecting 10 to 30% of all people who experience migraine. This type of migraine is typically accompanied by visual disturbances, such as seeing flashing lights, zigzag lines, or black spots. In this guide by Ada’s medical team, you can find more information on aura migraines, the possible symptoms, and treatment options. 

An aura migraine is a type of migraine that occurs following warning signs known as an aura. This migraine is also referred to as a classic migraine and affects about 10 to 30% of people who experience migraines. 1

Migraines with aura can cause several symptoms. You can experience the common signs of migraine, including: 2

• Throbbing, pulsating pain on one side of the head. This pain may affect the eye area but can occur anywhere in the head or the neck.
• Sensitivity to light, sound, and/or smell
• Vision changes
• Nausea
• Vomiting

Besides these common symptoms of a migraine, it’s also possible to experience: 

• Loss of appetite  
• Muscle tenderness  
• Impaired concentration  
• Fatigue  
• Anxiety
• Other symptoms

The aura that accompanies this type of migraine usually occurs moments before the actual migraine episode and can, therefore, be seen as a warning sign that you’re about to experience migraine. The symptoms of an aura can include: 2

• Visual disturbances such as seeing zigzag lines, black spots, or flashing lights
• Feeling numbness or a tingling feeling
• Difficulty speaking
• Dizziness

Although it’s more common to experience an aura before migraine, it’s also possible to experience the aura symptoms during the attack or afterward. In some cases, you can also experience an aura without migraine. 1

The causes of migraines with aura are not fully understood yet. We know that they result from inflammation near the nerves and blood vessels of the head. It’s also very likely that there’s a genetic factor involved in migraine, as people who have a close relative with migraine often experience episodes of migraines as well. There are a few triggers for migraine with aura which have been identified: 2

• Anxiety 
• Depression
• Stress
• Fatigue
• Menstruation 
• Not eating regularly 
• Certain foods
• Caffeine
• Not getting enough exercise

The aura preceding the migraine usually only lasts for an hour. The actual migraine episode can last anywhere between 2 hours and 3 days. You may experience fatigue some days before and after the headache. 3

A healthcare provider can diagnose a migraine with aura by: 4

• Checking symptoms along with medical, family, and overall health history.
• Looking at headache details to find triggers and see how attacks affect daily life. A migraine diary can provide your healthcare provider with useful information. 
• Using CT or MRI scans to rule out other causes of headaches by examining the brain.
• Performing a complete neurologic exam to check nerve function. Since migraines don’t cause lasting nerve damage, any nerve issues might suggest another problem. This exam usually includes tests of motor and sensory nerves, cranial nerves, reflexes, coordination, gait, and signs of irritation in the brain’s protective layers.

A migraine diagnosis is given when other causes are ruled out. After diagnosing a migraine, a healthcare provider can recommend treatments to help reduce the impact on daily life.

A migraine with typical aura symptoms can be treated in various ways. You can relieve your symptoms with medication as prescribed by your healthcare provider: 5

1. Non-steroidal anti-inflammatory drugs (NSAIDs)
   NSAIDs such as ibuprofen and aspirin can help reduce headache pain. Their anti-inflammatory properties are thought to help relieve a migraine’s characteristic throbbing/pulsing sensation. Depending on the type and strength, they can be purchased over the counter or prescribed.
2. However, NSAIDs are not suitable for long-term use, as they can cause complications, including gastrointestinal disorders. People who experience frequent migraine attacks and need regular pain relief should consult their doctor to explore the most appropriate treatment options.
3. Triptan medications
   Triptan medications should be taken at the first sign of a migraine starting. They work on the blood vessels and pain pathways that are associated with migraines. Your doctor might prescribe these if other medications haven't helped.
4. Ergotamine medications
   Ergotamine is derived from a fungus called ergot, and these medications can be used to provide instant migraine relief. Using ergotamine too frequently can, however, result in the development of chronic, persistent headaches.
5. “Good to know: Ergotamine medications should not be combined with triptans, as they are believed to have harmful cross-reactivity with one another.”
6. Opioid medications
   Opioid medications are more rarely prescribed and usually reserved as a short-term treatment where the above ones have not helped and are not recommended for long-term use. 

Preventing migraines relies on a combination of lifestyle changes and medications. 

Behavioral changes that are recommended for preventing migraine attacks include: 2

• Developing techniques to manage and reduce stress, such as deep breathing exercises and regular physical activity
• Keeping a diary to identify migraine triggers, such as exposure to strong smells, which can then be avoided if possible.
• Sleeping well and establishing a consistent sleep cycle are essential. Sleeping or lying down in a dark room can also help during a migraine episode.
• Staying hydrated, by drinking water and other non-alcoholic, non-caffeinated beverages throughout the day
• Establishing regular meal times and adopting a healthy, balanced diet.
• Devising a new medication plan with the healthcare provider if any medications that a person takes regularly are thought to be causing headaches.
• Following a safe weight-loss program is recommended for obese people affected by migraine headaches.

Where people have frequent attacks, medication may be prescribed to prevent migraine headaches. The medications that have been found most effective at migraine prevention include: 2

• Anticonvulsant medications (commonly used for epilepsy)
• A couple of blood pressure medications: Beta-blockers and calcium channel blockers.
• Antidepressants such as tricyclic antidepressants and selective serotonin reuptake inhibitors (SSRIs)
• OnabotulinumtoxinA (Botox®) injections are approved by the FDA as a treatment for chronic migraine

Finding the right preventative and relieving treatment, as well as the best lifestyle changes, can positively reduce the frequency and severity of attacks and their negative effects on life, work, and sleep. Talk to your doctor about what options might be best suited for you.

Migraine with aura is a classic form of migraine accompanied by visual disturbances such as flashing lights, zigzag lines, dizziness, and difficulty speaking. As the aura usually occurs before the actual migraine episode, it can be a warning sign that a migraine episode is about to happen. Medication can help alleviate migraine aura symptoms. Lifestyle changes can also help prevent migraine episodes. 

Q: What is an aura migraine
A: An aura migraine is a classic form of migraine that causes severe headaches on one side of the head, combined with visual disturbances such as seeing flashing lights or zigzag lines. 

Q: How to stop migraine aura? 
A: Medication for migraine with aura can help relieve the symptoms you’re experiencing. Your healthcare provider may prescribe you with non-steroidal anti-inflammatory drugs, triptans, ergotamine, or opioids. 
Q: How common is migraine with aura? 
A: Migraine with aura is quite a common type of migraine. About 10 to 30% of people who experience migraines also experience an aura before or during their migraine episodes.

Q: What causes an aura migraine?  
A: The cause of aura migraines is still unknown, although many triggers have been identified. Some triggers are anxiety, depression, stress, certain foods, caffeine, and changes to your sleep and eating patterns.