Learn more about migraine that causes pain and sensory disturbances (aura), such as flashes of light, blind spots or tingling in your hands or face.
Migraine with aura (also called classic migraine) is a recurring headache that strikes after or at the same time as sensory disturbances called aura. These disturbances can include flashes of light, blind spots, and other vision changes or tingling in your hand or face.
Treatments for migraine with aura and migraine without aura (also called common migraine) are usually the same. You can try to prevent migraine with aura with the same medications and self-care measures used to prevent migraine.
Migraine aura symptoms include temporary visual or other disturbances that usually strike before other migraine symptoms — such as intense head pain, nausea, and sensitivity to light and sound.
Migraine aura usually occurs within an hour before head pain begins and generally lasts less than 60 minutes. Sometimes migraine aura occurs without headache, especially in people age 50 and older.
Most people who have migraine with aura develop temporary visual signs and symptoms, which tend to start in the center of the field of vision and spread outward. These might include:
Other temporary disturbances sometimes associated with migraine aura include:
See your doctor immediately if you have new signs and symptoms of migraine with aura, such as temporary vision loss, speech or language difficulty, and muscle weakness on one side of your body. Your doctor will need to rule out more-serious conditions, such as a stroke.
There is evidence that the migraine aura is due to an electrical or chemical wave that moves across the brain. The part of the brain where the electrical or chemical wave spreads determines the type of symptoms you might experience.
This electrical or chemical wave can occur in areas that process sensory signals, speech centers or centers that control movement. The most common type of aura is visual aura, which occurs when a wave of electrical activity spreads through the visual cortex and causes visual symptoms.
The electrical and chemical waves can occur with normal functioning of the nerves and do not cause harm to the brain.
Many of the same factors that trigger migraine can also trigger migraine with aura, including stress, bright lights, some foods and medications, too much or too little sleep, and menstruation.
Although no specific factors appear to increase the risk of migraine with aura, migraines in general seem to be more common in people with a family history of migraine. Migraines are also more common in women than in men.
People who have migraine with aura are at a mildly increased risk of stroke.
Your doctor might diagnose the migraine with aura based on your signs and symptoms, your medical and family history, and a physical exam.
If your aura isn't followed by head pain, your doctor might recommend certain tests to rule out more-serious conditions, such as a transient ischemic attack (TIA).
Assessments might include:
Your doctor might refer you to a doctor who specializes in nervous system disorders (neurologist) to rule out brain conditions that could be causing your symptoms.
For migraine with aura, just as with migraine alone, treatment is aimed at relieving migraine pain.
Medications used to relieve migraine pain work best when taken at the first sign of an oncoming migraine — as soon as signs and symptoms of a migraine aura begin. Depending on how severe your migraine pain is, types of medications that can be used to treat it include:
Pain relievers. These over-the-counter or prescription pain relievers include aspirin or ibuprofen (Advil, Motrin IB, others). When taken too frequently, these might cause medication-overuse headaches, and possibly ulcers and bleeding in the gastrointestinal tract.
Migraine relief medications that combine caffeine, aspirin and acetaminophen (Excedrin Migraine) may be helpful, but usually only against mild migraine pain.
Dihydroergotamine (D.H.E. 45, Migranal). Available as a nasal spray or injection, this drug is most effective when taken shortly after the start of migraine symptoms for migraines that tend to last longer than 24 hours. Side effects can include worsening of migraine-related vomiting and nausea.
People with coronary artery disease, high blood pressure, or kidney or liver disease should avoid dihydroergotamine.
Calcitonin gene-related peptide (CGRP) antagonists. Ubrogepant (Ubrelvy) and rimegepant (Nurtec ODT) are oral CGRP antagonists recently approved for the treatment of acute migraine with or without aura in adults. In drug trials, drugs from this class were more effective than placebo in relieving pain and other migraine symptoms such as nausea and sensitivity to light and sound two hours after taking it.
Common side effects include dry mouth, nausea and excessive sleepiness. Ubrogepant and rimegepant should not be taken with strong CYP3A4 inhibitor drugs.
Some of these medications are not safe to take during pregnancy. If you're pregnant or trying to get pregnant, don't use any of these medications without first talking with your doctor.
Medications can help prevent frequent migraines, with or without aura. Your doctor might recommend preventive medications if you have frequent, long-lasting or severe headaches that don't respond well to treatment.
Preventive medication is aimed at reducing how often you get a migraine headache with or without aura, how severe the attacks are, and how long they last. Options include:
Ask your doctor if these medications are right for you. Some of these medications are not safe to take during pregnancy. If you're pregnant or trying to get pregnant, don't use any of these medications without first talking with your doctor.
When symptoms of migraine with aura start, try heading to a quiet, darkened room. Close your eyes and rest or take a nap. Place a cool cloth or an ice pack wrapped in a towel or cloth on your forehead.
Other practices that might soothe migraine with aura pain include:
If you're having temporary visual or sensory disturbances, see your family doctor. In some cases, you may be referred to a doctor who specializes in nervous system disorders (neurologist).
Here's information to help you get ready for your appointment.
For migraine with aura, some questions to ask your doctor include:
Don't hesitate to ask other questions you have.
Your doctor is likely to ask you a number of questions, including:
July 2nd, 2021