Migraine aura symptoms

Overview

A migraine aura is a temporary set of sensory changes that happen just before or during a migraine headache. It most often affects your vision, but can also affect your other senses or your ability to speak. The aura usually builds up over a few minutes and lasts up to an hour.

Migraine aura is fairly common among people who get migraines. About 20% of people with migraine experience aura at least sometimes.

Migraine aura can affect people of any age, but it is more common in women and often starts in the teenage years or early adulthood.

Symptoms

Common symptoms

• Visual changes: seeing flashing lights, zigzag lines, blind spots, or colored spots.
• Sensory changes: tingling or numbness that spreads slowly, often over the face or hand.
• Speech or language problems: trouble speaking clearly or finding the right words.
• Other symptoms: dizziness, weakness on one side of the body (rare).

Symptoms in children

• Children may have trouble describing what they see. They might say things like 'I see sparkles' or 'things look funny'.
• Aura in children can also cause stomach pain, dizziness, or confusion.
• Children may become pale, irritable, or want to lie down in a dark room.

Symptoms in older adults

• Older adults may have aura without any headache (called 'migraine aura without headache').
• Visual symptoms like blind spots or flickering lights are more common.
• Aura in older adults can sometimes be confused with a transient ischemic attack (TIA) or stroke, so it is important to see a doctor.

Causes

Main causes

• Migraine aura is thought to be caused by a wave of electrical activity that spreads across the brain, followed by a brief reduction in blood flow.
• This wave (called 'cortical spreading depression') triggers the sensory symptoms.
• The exact reason this happens is not fully understood, but it is linked to changes in brain chemicals and nerve signals.

Risk factors

• Family history of migraine (genetics play a strong role).
• Hormonal changes, especially in women around their menstrual period.
• Stress, lack of sleep, or changes in sleep patterns.
• Certain foods or drinks (like aged cheese, red wine, caffeine withdrawal).
• Weather changes, bright lights, or strong smells.

When to see a doctor

See a doctor urgently if:

• If you have aura symptoms for the first time after age 50.
• If your aura lasts more than 1 hour or comes with unusual symptoms like fever, stiff neck, or weakness on one side of the body.
• If you have a headache that starts very suddenly and severely.

Book a routine appointment if:

• If you think you have migraine aura for the first time at any age.
• If your aura pattern changes (e.g., happens more often, lasts longer, or new symptoms appear).
• If migraine headaches interfere with your daily life or sleep.

Diagnosis

Doctors usually diagnose migraine aura based on your medical history and a description of your symptoms. They will ask about your headache patterns, aura symptoms, triggers, and family history.

Tests that may be done

• No specific test is needed for migraine aura itself.
• If your symptoms are unusual or if the doctor wants to rule out other conditions, they may order an MRI or CT scan of your brain.
• Sometimes an eye exam is done to make sure the vision symptoms are not caused by eye problems.

What to expect at your appointment

Your doctor will listen carefully to your symptoms. They may ask you to keep a headache diary to track your attacks, triggers, and how long the aura lasts. This information helps confirm the diagnosis and plan the best way to manage your migraine.

Treatment

Treatment for migraine aura focuses on managing the migraine attacks and preventing future ones. There is no cure, but many people find relief with the right approach.

Self-care at home

• Rest in a quiet, dark room when an aura or headache starts.
• Apply a cold or warm compress to your forehead or neck.
• Drink water and avoid known trigger foods.
• Try relaxation techniques like deep breathing or gentle stretching.

Medical treatments

Medications are available to stop a migraine attack once it starts (abortive treatments) and to reduce how often attacks happen (preventive treatments). Your doctor can discuss the options that are safe and appropriate for you. Never take someone else’s prescription. Treatment plans are tailored to your specific symptoms and health background.

When is surgery considered?

Surgery is not a standard treatment for migraine with aura. Only in very rare, severe cases that do not respond to other treatments might procedures like nerve stimulation be considered – this would be discussed by a specialist.

Living with this condition

Living with migraine aura means learning to manage triggers and respond early when symptoms appear. Many people keep a diary to spot patterns and avoid things that set off their migraine.

Lifestyle tips

• Keep a regular sleep schedule – go to bed and wake up at the same time every day.
• Manage stress with yoga, meditation, or talking to a friend.
• Avoid skipping meals – eat regular, balanced meals.
• Stay hydrated by drinking plenty of water throughout the day.

Diet and exercise

Eat a healthy, balanced diet and avoid foods you notice are triggers. Regular, gentle exercise like walking, swimming, or cycling can help reduce the frequency of migraines. But very intense exercise can sometimes trigger an attack, so listen to your body.

Mental health and emotional wellbeing

Migraine aura can be frightening, especially the first time it happens. The unpredictability of attacks can lead to anxiety or worry about the next episode. It is normal to feel frustrated or sad. If these feelings affect your daily life, talk to your doctor or a mental health professional. You are not alone.

Prevention

You cannot always prevent migraine aura, but you can reduce how often attacks happen. This includes avoiding known triggers, managing stress, and sometimes taking preventive medication as prescribed by your doctor.

Complications

If left untreated

• Rarely, a prolonged migraine aura (over 60 minutes) may be linked to a slightly higher risk of stroke, especially in women who smoke or take hormonal contraceptives.
• Frequent migraines can affect work, school, and relationships if not managed.

Long-term outlook

Most people with migraine aura lead full, active lives. With the right treatment and lifestyle changes, many are able to reduce the number of attacks and cope well when they happen. New treatments are constantly being developed, and the outlook is generally good.

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