What is a migraine aura?

A migraine aura is a visual, motor, sensory or verbal disturbance that usually happens right before a migraine headache. Migraine auras can last from 20 to 60 minutes and may start before the migraine headache or at the same time as the headache. Though rare, it’s also possible to get a migraine aura without a headache.

About 25 to 30% of people with migraine headaches get auras. Migraine aura affects different systems in your body, including:

• Visual: seeing stars, flashes, zigzag lines; or even losing vision for brief periods
• Sensory: numbness or tingling in the body, hands, fingers and face
• Verbal: slurring words or mumbling; not being able to speak properly
• Motor: weakness, tingling or paralysis on one side of your body known as hemiplegia

Researchers are not sure what causes aura. They’ve used magnetic resonance imaging (MRI) to study people with migraine aura. It’s likely that aura is caused by changes in nerve signals or impulses affecting normal brain activity. These changes can be seen on an MRI. While aura is bothersome, it’s not dangerous.

Migraines can cause structural changes in the brain that can be seen on an MRI. However, there is no evidence that these changes impair brain function or the way you think now or later in life.

People who get migraine headaches with or without aura have an increased chance of having a stroke in their lifetime. That’s why it’s important to keep track of aura symptoms and seek help right away if you have:

• Sudden, severe aura that lasts for more than 1 hour
• An aura that does not go away when the migraine headache goes away
• Loss of consciousness
• Weakness on one side of the face or body

Some people experience aura and never get a headache after it. This is a rare condition that affects about 4% of people diagnosed with migraine. An aura without headache usually causes changes in vision. Sometimes, sensory and verbal disturbances also occur. Treatment for this condition may be different from the treatments for migraine headaches with aura. A physical exam, bloodwork and other tests can help determine if you have migraine aura or a different diagnosis.

Relief for migraine with aura

Treatment for migraine headaches with and without aura include:

• Over-the-counter (OTC) medicines such as:
  • Tylenol (acetaminophen)
  • Advil or Motrin (ibuprofen)
  • Aleve (naproxen)
  • Excedrin (acetaminophen-aspirin-caffeine)

Keeping track of how often these medicines are taken is important. A condition known as rebound headache can happen if they are used too much.

• Prescription medicines known as triptans:
  • Imitrex (sumatriptan)
  • Maxalt (rizatriptan)
  • Amerge (naratriptan)
  • Frova (frovatriptan)
  • Relpax (eletriptan)
  • Zomig (zolmitriptan)
  • Ergot-derivative prescription drugs such as:
  • Cafergot (ergotamine tartrate and caffeine)
  • Migranal (dihydroergotamine)

There are other prescription medicines that may help prevent migraine with aura as well. These include:

• High blood pressure medicines such as:
  • Tenormin (atenolol)
  • Toprol (metoprolol)
  • Corgard (nadolol)
  • Inderal (propranolol)
  • Cardizem (diltiazem)
  • Calan (verapamil)
• Anti-seizure medicines such as:
  • Topamax (topiramate)
  • Depakote (divalproex)
• Antidepressants such as:
  • Elavil (amitriptyline)
  • Pamelor (nortriptyline)
  • Cymbalta (duloxetine)
  • Effexor (venlafaxine)
• Botox (onabotulinumtoxinA)
• Calcitonin gene-related peptide (CGRP) inhibitors that are monoclonal antibodies such as:
  • Aimovig (erenumab-aooe)
  • Ajovy (fremanezumab)
  • Emgality (galcanezumab-gnlm)
  • Vyepti (eptinezumab-jjmr)

Two CGRP receptor-antagonists (gepants) are approved for both prevention and treatment. These are:

• Ubrelvy (ubrogepant)
• Nurtec ODT (rimegepant sulfate)

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Prevention tips

Here are some other tips to help prevent migraine with aura:

• Maintain a regular sleep schedule, even on weekends
• Drink plenty of water to keep hydrated
• Get regular exercise
• Ask your doctor about magnesium or other supplements. This may help prevent migraines.

Learn what triggers your migraine with aura. Keep a headache diary and write down what happened in the days leading up to, and right before, your migraine aura. Some things to keep track of include:

• Foods or drinks you may have had
• Having too much caffeine or not enough water
• Feeling tired, irritable or anxious
• Changes in weather