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Aura

There are two main types of migraine: migraine with aura – which used to be called classic migraine – and migraine without aura – which was once called common migraine. Sometimes a person living with migraine can have migraine attacks with or without aura. Aura is often a sign to the person that a migraine will appear soon.

What is an aura?

Aura is a cluster of sensory disturbances that happen shortly before a migraine attack and usually lasts 20 to 60 minutes.1 There can be a variety of symptoms and levels of sensory changes, which can sometimes be alarming to the person experiencing it.

Aura typically occurs during the first phase, also known as prodrome, before the head pain commonly felt during the second phase of a migraine attack. Aura does not occur in all people with migraine. Roughly 25 percent to 30 percent of people living with migraine experience migraine with aura.1 Those who do experience aura, do not necessarily experience aura with each migraine. There are also some people who experience migraine aura without head pain.2 These are also known as “silent migraine.”

Symptoms of aura are often grouped into 3 categories:1

  • Vision disturbances: spots, flashes, stars, brief loss of vision, zig-zags
  • Sensory changes: tingling or numbness in the face, hands, fingers, or body
  • Speech or language issues: not being able to correctly say words or slurring

Visit the migraine phases page to learn more about the phases of a migraine attack, including common symptoms experienced during aura.

Why does aura occur?

It is not known for sure what causes aura. However, when people living with migraine undergo MRI (magnetic resonance imaging) during aura, in certain patients, the changes in the brain (officially called a cortical spreading depression) can be seen slowly moving across part of the brain. It is thought that auras are caused by a wave of nerve signals or impulses that move across the brain, causing a disruption in normal activity in those parts of the brain.2 These changes are also thought to cause a wide range of migraine symptoms.

More research needs to be done to fully understand the causes of aura and how to better treat it.

How is aura treated?

Treatment of migraine with aura typically includes a mix of drugs for both prevention and acute treatment. You should call your doctor if you experience any of the following:

  • If you feel a sharp onset of symptoms or the aura lasts longer than 1 hour
  • If the aura is not resolved with treatment of the migraine attack, call your doctor
  • If you have symptoms of weakness on 1 side of the body or a change in consciousness or alertness, you should call your doctor immediately because this may be a symptom of stroke. Migraine with aura can increase your risk of stroke, so it is important to address any abnormal symptoms as soon as possible.1

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Tracking your migraine symptoms

Keeping a record of your migraine symptoms may help you figure out patterns and triggers to your attacks. It may be helpful to record such things as:

  • When and where your pain or symptoms start
  • Whether the pain spreads to your entire head or neck
  • How well and how quickly acute treatment helps reduce the pain or other symptoms
  • How long your pain or symptoms last
  • Whether you experience other symptoms such as vision changes, nausea, or light sensitivity

Community experiences of migraine and aura

Migraine.com advocates often write about their experiences with migraine and aura. For those who experience aura, it can be part of a long list of warning signs a migraine attack is coming on. In this video, one advocate illustrates how her field of vision changes during this prodrome phase. Others may face challenges in getting an accurate diagnosis of persistent migraine aura.

Written by: Jessica Johns Pool | Last review date: December 2019
  1. Understanding Migraine with Aura. American Migraine Foundation. Available at: https://americanmigrainefoundation.org/resource-library/understanding-migraine-aura/ Accessed 11/22/19.
  2. Hansen JM & Charles A. Differences in treatment response between migraine with aura and migraine without aura: Lessons from clinical practice and RCTs. The Journal of Headache and Pain. 2019 September; 20(9). Doi: https://doi.org/10.1186/s10194-019-1046-4