Migraine Aura

Reviewed by: HU Medical Review Board | Last reviewed: August 2014

When people think of migraines, the symptoms of migraine aura are most often the migraine symptoms that come to mind. These symptoms, which include seeing flashing lights and feeling tingling, typically set migraines apart from other types of headaches.

All migraines fall into two main classifications: migraine with aura and migraine without aura.

Who experiences migraine aura?

Migraine aura impacts about 10 million migraine sufferers in the U.S. and refers to the range of symptoms that strike before the head pain begins. The migraine aura symptoms include vision changes, changes in the other senses and other symptoms.

For the one-third of sufferers who experience migraine aura, the aura symptoms don’t always occur with each and every attack. Others may experience migraine aura without the head pain phase of an attack.

What is required to diagnose migraine with aura?

  • At least two episodes of aura with migraine headache
  • One or more of the following fully reversible aura symptoms: visual, sensory, speech and/or language, motor, brainstem, retinal
  • At least 2 of the following 4 characteristics: (1) at least 1 aura symptom spreads gradually over  ≥5 minutes, and/or 2 or more symptoms occur in succession, (2) each individual aura symptom lasts 5-60 minutes, (3) at least 1 aura symptom is unilateral, (4) the aura is accompanied, or followed within 60 minutes, by headache
  • Symptoms not attributed to another disorder

In many older patients who suffered from attacks in their younger years find that the head pain begins to go away. However, often the aura symptoms remain. If the aura symptoms begin for the first time after age 40, doctors become more concerned because the symptoms could be caused by a more serious disorder and other possible diagnoses must be ruled out.

What are the different types?

  • Migraine with typical aura
  • Migraine with brainstem aura
  • Retinal migraine

How can keeping a journal help?

As with all types of migraines, sufferers should keep a migraine journal. This diary or log should contain every detail about each migraine attack, including what you were during prior to the attack, what symptoms you experienced, how long the symptoms last and the intensity of the symptoms. This migraine journal will help your doctor diagnose migraines and identify your triggers list.

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