Migraine with Aura

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

About 1 in 3 people with migraine also have what is called aura. Aura is a series of changes to the senses, such as seeing spots or feeling tingling on the face. Each sensory change comes on slowly and lasts 20 minutes to 1 hour.1,2

For most people, head pain follows the migraine aura symptoms. In a few cases, people have aura but no head pain. Aura may also overlap with head pain.

Migraine with aura subtypes

There are 5 subtypes of migraine with aura. These include:2

What causes migraine with aura?

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 and the head pain that follows the aura stage.3

Migraine with aura symptoms

Aura symptoms tend to happen 1 after another, with each lasting 20 minutes to 1 hour. The most common order of changes are visual, sensory, and then trouble with speaking. More than 9 out of 10 people who have migraine with aura have vision changes, such as:2,4

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

Other symptoms of migraine aura include:4

  • Hearing loss or ringing of the ears
  • Being hypersensitive to touch, sounds, or smells
  • Hearing sounds that are not there (auditory hallucinations)
  • Smelling odors that are not there (olfactory hallucinations)
  • Feelings of burning, pain, tingling, or numbness, often in the face, hands, or feet
  • Vertigo or dizziness
  • Loss of feeling, or inability to move a part of the body such as the tongue

Problems with language or speaking are less common aura symptoms. Alice in Wonderland Syndrome is a rare form of migraine aura in which the person feels like their body or objects around them are much bigger or smaller than they actually are. It is most common in children.5

Diagnosing migraine with aura

Migraine with aura is diagnosed using the person’s description of their symptoms. This is why keeping a migraine diary can be so helpful in finding treatments and understanding your own triggers. Sometimes tests may be ordered to rule out other health problems that cause similar symptoms.

According to the International Headache Society, someone has migraine with aura if they have 2 attacks that look like this:2

  • At least 1 aura symptom that goes away completely in between attacks
  • Aura symptoms spread slowly over 5 minutes or more
  • Two or more aura symptoms happen one after the other
  • Each aura symptom lasts between 5 minutes and 1 hour

Treatments for migraine with aura

Migraine with aura is treated with both preventive and acute medicines. People who have migraine with aura have a higher risk of stroke than the general population so if symptoms start suddenly, the aura lasts more than 1 hour, you faint, or feel weakness on 1 side of the body, see a doctor immediately.

Old names for migraine with aura include:2

  • Classic migraine
  • Ophthalmic migraine
  • Hemiplegic or aphasic migraine
  • Complicated migraine

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