Everything You Need To Know About Migraine Aura

By Andrew Yocum, MD
Medically reviewed checkmarkMedically reviewed
June 17, 2022

Migraine headaches can cause several uncomfortable symptoms, from a severe headache on one side of your head to nausea, vomiting, and sensitivity to light and sound.

For some people, a migraine episode also comes with a neurological disturbance known as an aura.

A migraine aura can occur before or during a headache, and in some cases, without a headache at all.

If you get migraines with aura, it’s important to tell your doctor about your symptoms.

A healthcare provider may want to rule out other medical problems.

If you’re diagnosed with migraine aura, your provider can recommend a treatment that may relieve your symptoms. 

In this article, I’ll explain what a migraine aura is and what causes it.

I’ll explore migraine aura symptoms, diagnosis, treatment, and prevention.

Lastly, I’ll explain when to see a doctor for a migraine aura. 

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What Is a Migraine Aura? 

A migraine is a type of headache that causes throbbing or pulsing pain, usually on one side of the head.

According to the American Migraine Foundation, up to 30% of people with migraine experience a neurological symptom known as an aura.

Auras can cause several sensory disturbances, from seeing dots and zig-zags to tingling on either side of your face or body.

For many migraine sufferers, the aura is considered a warning sign that happens 30-60 minutes before the actual headache.

Sometimes, aura can happen with the headache, and other times, people with an aura may not ever get a headache. 

Different types of auras

There are a few different kinds of migraine aura: 

  • Visual auras: This type of aura causes temporary changes in a person’s vision, such as vision loss, flashing lights, dots, or zig-zags.
  • Sensorimotor auras: This type of aura causes tingling, weakness, or numbness, usually on one side of a person’s face or body.
  • Dysphasic auras: This type of aura causes verbal symptoms such as slurred speech. 

What Causes a Migraine Aura?

Experts believe migraine aura is caused by an electrical wave that moves across the brain.

Aura symptoms may depend on the part of the brain where this wave occurs.

For example, someone might experience a visual aura if the electrical wave happens in their visual cortex, the part of the brain associated with vision. 

Migraine aura can happen to anyone, but it’s more common in people with vaginas, and it’s thought that genetics may predispose people to experiencing them.

Many of the same environmental factors that trigger a migraine headache can cause a migraine with aura, including: 

  • Hormonal changes, such as menstruation
  • Caffeine 
  • Alcohol
  • Dehydration
  • Stress
  • Sleep deprivation
  • Weather changes
  • Certain foods, such as aged cheese and cured meats
  • Monosodium glutamate (MSG), a common food additive
  • Artificial sweeteners, such as aspartame
  • Skipping meals
  • Bright lights
  • Strong smells
  • Certain medications, such as birth control and vasodilators

Is it possible to have an aura without a headache? 

Also called a “silent migraine,” an aura can occur without a headache during or after it.

Usually, the aura happens gradually over the course of minutes.

Keep in mind that a migraine aura without a headache can mimic symptoms of a stroke.

Call 9-1-1 or visit the emergency room if you have any of the below signs: 

  • Sudden neurological disturbances
  • Aura that doesn’t go away after 60 minutes
  • Weakness only on one side of your body 
  • Confusion
  • Loss of consciousness

Symptoms

Migraine aura symptoms vary, and they depend on the type of aura that’s occurring.

Some of the most common symptoms of a migraine aura include: 

  • Seeing zigzag lines, spots, or stars in your visual field
  • Changes in your vision or vision loss 
  • Flashes of light
  • Numbness or tingling in one hand or one side of your face
  • Slurred speech or mumbling 
  • Muscle weakness

In many cases, a migraine headache also occurs with an aura, either during or after it.

Migraine symptoms may include: 

  • A headache on one or both sides of your head
  • Throbbing or pulsating pain 
  • Nausea and/or vomiting 
  • Sensitivity to light, sound, or smell

Diagnosis

If you think you may have migraine with aura, talk to your primary care provider or a K doctor.

Your provider will ask you about your medical history and symptoms, along with performing a physical exam. 

In some cases, your doctor may want to rule out other medical problems, like a type of stroke called a transient ischemic attack (TIA).

You may also get an eye exam to ensure an eye condition isn’t causing your visual problems.

Your doctor might refer you to a neurologist, who specializes in brain disorders, to rule out brain conditions that could mimic a migraine aura.

Never diagnose yourself with migraine with aura until you have been evaluated by a doctor.

Treatment

Medications taken at the first sign of an aura can help relieve pain from migraine attacks.

If your migraines are not severe, over-the-counter analgesics (such as acetaminophen, or Tylenol) or non-steroidal anti-inflammatory drugs (such as ibuprofen, aspirin, or naproxen) may help. 

If your migraine doesn’t respond to OTC drugs alone, your doctor may recommend prescription medication as a treatment option. Common migraine treatments include: 

  • Triptans: These drugs, such as sumatriptan (Imitrex) and rizatriptan (Maxalt), can relieve migraines by blocking pain signals in the brain and constricting blood vessels that widen and put pressure on the brain.
  • Dihydroergotamine: This medication, which is available as a nasal spray or injection, is most helpful for people whose migraines last at least 24 hours. Examples include D.H.E. 45 and Migranal.
  • CGRP (calcitonin gene-related peptide) antagonists: This drug can block a brain receptor that causes pain. Examples include ubrogepant (Ubrelvy) and rimegepant (Nurtec ODT).
  • Anti-nausea drugs: If your migraine includes nausea and vomiting, your doctor may recommend drugs such as chlorpromazine (Thorazine), metoclopramide (Reglan) or prochlorperazine (Compazine).

Prevention 

If you get severe migraines or frequent migraine with aura, your doctor may recommend a preventative drug.

Examples of drugs that can help prevent migraines include: 

  • Beta-blockers, such as propranolol (Inderal) and Timolol (Timoptic-xe, Istalol, Timoptic)
  • Tricyclic antidepressants, such as amitriptyline (Elavil, Vanatrip)
  • Anticonvulsants, or anti-seizure drugs, such as sodium valproate Dyzantil, Epilim, Episenta, Epival) and topiramate (Topamax, Topiragen, Qudexy DR, Trokendi-XR2) 

If you get migraines with or without aura, keeping a headache diary with details about your migraine attacks can help you avoid the triggers that cause them.

You may also want to try these healthy lifestyle changes to prevent a migraine with aura: 

  • Getting enough sleep 
  • Keeping a consistent sleep routine
  • Drinking enough water
  • Eating a healthy diet
  • Controlling your stress levels
  • Reducing alcohol consumption 
  • Exercise, including meditation and yoga practices

When To See a Medical Provider

Migraine auras can be uncomfortable, and a doctor can help to diagnose you and find a treatment plan that relieves your symptoms.

If you’re taking medication for migraine aura but it’s not helping, or you experience a change in your aura symptoms, you should also see a medical provider. 

If your sensory symptoms aren’t accompanied by a headache and you’re concerned about a stroke, call 9-1-1 or visit the emergency room right away.

The following signs may signal a stroke: 

  • Sudden neurological disturbances
  • Aura that doesn’t go away after 60 minutes
  • Weakness only on one side of your body 
  • Confusion
  • Loss of consciousness
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How K Health Can Help 

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Frequently Asked Questions

Are migraine auras serious?
Migraine auras can be disturbing, but they usually resolve on their own. If you think your aura symptoms may be something else, talk to a doctor. In rare cases, more serious medical conditions, such as a stroke, can cause neurological disturbances similar to an aura.
What does a migraine aura feel like?
A migraine aura can cause several different neurological symptoms, from visual disturbances to sensory ones. Often, but not always, a migraine aura happens before or during a migraine headache. People often describe migraines as throbbing or pulsing pain, and they can occur on one side of the head or cause pain on both sides.
K Health articles are all written and reviewed by MDs, PhDs, NPs, or PharmDs and are for informational purposes only. This information does not constitute and should not be relied on for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.

K Health has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. We avoid using tertiary references.

Andrew Yocum, MD

Dr Andrew Yocum is a board certified emergency physician. He graduated Summa Cum Laude from Kent State University with a Bachelor of Science in Molecular Biology before attending Northeast Ohio Medical University where he would earn his Medical Doctorate (MD).

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