About a third of the over 37 million migraine sufferers in the U.S. experience migraine with aura. With this type of migraine, a group of migraine symptoms occurs before the head pain begins. The symptoms, which are usually vision changes or odd sensations in other parts of the body, happen most often 30 minutes before the migraine attack’s pain. Aura is considered a warning sign or migraine prodrome.
Aura has become closely associated with migraines, so much that migraine with aura was formerly called classic migraine, while migraine without aura was called common migraine.
Some of the symptoms of migraine with aura can also be considered separate migraine symptoms, therefore correctly diagnosing the migraine type can be tricky. For example, photophobia (sensitivity to light) is a common migraine symptom and similar to the vision changes that often occur in most types of migraines.
Those who have migraine with aura often complain of seeing jagged light in the peripheral vision or a flickering light during the aura.
What causes migraine with aura?
When patients undergo a migraine MRI, magnetic resonance imaging test during aura, gradual changes in the brain can be seen moving from one part of the brain to another. It is called a cortical spreading depression. This wave of brain activity is also thought to trigger the head pain that follows migraine aura.
Common visual symptoms of migraine with aura
- Seeing flashes or flickering light
- Seeing zigzag lines or waves, also called fortification illusions
- Seeing spots, stars, halos, circles, lines, other shapes or colors
- Blurry vision
- Loss of vision
- Cloudy vision
- Other vision changes
- Seeing three-dimensional effects
- Seeing dark areas
Diagnosing migraine with aura
To be diagnosed with migraine with aura, a migraine sufferer must have at least two attacks of neurological disturbances, which may include vision changes or changes in the other senses. These attacks usually strike gradually over five to 20 minutes and less for less than an hour. Most of the time, head pain follows the migraine aura symptoms. In a few cases, patients do not experience any head pain. As with all migraine diagnosis, all other conditions that might cause the symptoms have been ruled out. In the most recent guidelines for diagnosing migraine (ICHD-III), migraine with aura has been broken into the following sub-categories: migraine with typical aura, migraine with brainstem aura, hemiplegic migraine, and retinal migraine.
Some migraine sufferers only experience migraine with aura, while others may have migraine attacks with aura and some without aura. Although the aura symptoms usually come soon before the head pain sets in, sometimes the aura symptoms may occur a day or two in advance.
A 1996 study of 163 people who suffer from migraine with aura found the following migraine statistics:
- Vision changes, 99 percent
- Aura symptoms but no head pain, 42 percent experienced it and 10 percent never had head pain
- Changes in other senses, 31 percent
- Difficulty speaking, writing and comprehending, called aphasia, 18 percent
- Motor symptoms, such as weakness or difficulty moving, 6 percent
Those who experienced visual aura had the following migraine symptoms:
- Seeing zigzag lines, 81 percent
- Flickering light, 87 percent
- Pain on one side of head, 69 percent
- Vision changes starting in the middle of the eyesight, 62 percent
- Vision changes starting in the peripheral vision, 28 percent
- White is the color seen, 47 percent
- Rainbow colors seen, 12 percent
Those who experienced sensory aura, or a change in the senses, had the following symptoms:
- Pain on one side of head, 84 percent
- Sensations in the hand, 96 percent
- Odd feelings in the arm, 78 percent
- Weird feelings in the face, sometimes numb face, 67 percent
- Different sensations in the tongue, 62 percent
- Changes in the foot, 24 percent
- Sensations in the leg, 24 percent
- The whole body, 18 percent