Migraine with Typical Aura

Reviewed by: HU Medical Review Board | Last reviewed: October 2020

Migraine with typical aura (MTA) is the most common form of migraine with aura. Aura is the word for the sensory changes that some people with migraine have. The most common aura symptoms are changes to vision, feel, and speech, so those are called “typical” aura.1

How are head pain and aura related?

Head pain usually follows aura symptoms about 1 hour later. Some people who have migraine with aura sometimes have little to no head pain. Women are slightly more likely than men to experience migraine with aura.1,2

Whether head pain happens after or during the typical aura phase can be different from person to person. One study found that 7 out of 10 people have head pain during the aura phase, with about half of headaches occurring within 15 minutes of the aura symptoms.2

For people who have head pain following typical aura, the most common symptoms are:3

  • Moderate to severe pain on one side of the head
  • Pulsating or throbbing pain
  • Pain made worse by movement
  • Nausea
  • Sensitivity to light and sound

What are the symptoms of this type of migraine?

Changes in vision are the most common kind of typical aura. More than 9 out of 10 people who have migraine with typical aura have vision changes, such as:1

  • Seeing spots, flashes, flickering light, zig zag or wavy lines, or stars
  • Cloudy or blurry vision
  • Blind spots or losing vision for a short time

Other aura symptoms include:1

  • Being hypersensitive to touch, sounds, or smells
  • Smelling odors that are not there (olfactory hallucinations)
  • Feelings of burning, pain, tingling, or numbness, often in the face, hands, or feet
  • Trouble speaking or slurred speech
  • Trouble reading or writing

Like other forms of migraine with aura, each symptom gradually builds over 5 to 20 minutes and lasts up to 1 hour.1

What causes migraine with typical aura?

Doctors currently believe that migraine aura is caused by what is known as cortical spreading depression. Cortical spreading depression is a type of electrical activity that moves from 1 part of the brain to another. Doctors believe this brain activity causes aura.4

Most people with migraine learn that certain things trigger their migraine attacks. Common triggers include:5

How is it diagnosed?

A person is diagnosed with migraine with aura if they have 2 or more attacks with at least 1 typical aura symptom that disappeared by the end of the migraine attack. Each attack must also meet 2 more conditions:1,3

  • At least 1 typical aura symptom spreads gradually over at least 5 minutes
  • 2 or more symptoms occur 1 after the other
  • Each aura symptom lasts between 5 minutes and 1 hour
  • At least 1 aura symptom is limited to 1 side of the body
  • Aura symptoms appear at the same time as the head pain or head pain follows within 1 hour

People who have vertigo, slurred speech, ringing in the ears, or double vision have migraine with brainstem aura. People who have muscle weakness on 1 side of the body as their aura have hemiplegic migraines. People who have temporary blindness in 1 eye as their aura have retinal migraines.

Depending on your symptoms, your doctor may need to run tests to rule out transient ischemic attacks or stroke. This is especially important for women with migraine (who are at a slightly higher risk of stroke), people who have their first migraine aura after age 40, and in cases when aura are either very brief (less than 5 minutes) or very long-lasting (more than 1 hour).1

How is it treated?

A migraine diary can help you and your doctor better understand your specific aura symptoms and this information can play an important role in finding the best treatments for you. Common treatment options for migraine with typical aura include:3

  • Pain-relievers triptans, ergotamines, dopamine blockers, and anti-nausea drugs
  • Preventive drugs
  • Stress management
  • Avoiding triggers

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