What is migraine with aura?

About one in three people with migraine have this type of migraine.

Symptoms

The warning sign is most commonly a symptom that affects your sight, such as blind spots or seeing flashing lights.

Auras can either happen on their own or together with the symptoms of a migraine without aura. The auras usually happen before a headache, which could be severe or mild. In some people the headache may not happen.

Auras usually start happening gradually over about five minutes and last for up to an hour.

Auras are most commonly to do with your sight. Your speech can also be affected. Some people feel disoriented or confused, or can faint, although this is rare.

The common symptoms related to your sight include:

• blind spots
• seeing coloured spots or lines
• seeing flashing or flickering lights
• seeing zig zag patterns
• temporary blindness

Other aura symptoms can include:

• numbness or tingling sensation like pins and needles in parts of your body
• muscle weakness
• feeling dizzy or off balance

Subtypes of migraine with aura

Subtypes of migraine with aura include migraine with brainstem aura, hemiplegic migraine and retinal migraine.

What causes migraine with aura?

It is not known exactly what causes auras.

Scientists have looked into it and found that it may be caused by a slow wave of altered brain activity called ‘cortical spreading depression’. This leads to temporary changes in the chemicals, nerves and blood flow in the brain that affect how it works and could be related to pain.

Improving understanding of how these changes in the brain can lead to headache will help with the discovery of new drugs that could prevent migraine attacks.

Treatment options for migraine with aura

Your treatment options depend on how often you have attacks and how severe they are. It will also depend on other factors such as other illnesses you may have or medication that you take.

Generally, treatment for migraine includes:

• Acute treatment such as over the counter painkillers, migraine specific treatments (triptans) and anti-sickness medication. These treatments aim to help manage the symptoms when an attack comes on. You do need to be careful not to take certain acute treatments too many days a month as this can cause medication overuse headache. Medication overuse can cause daily headaches with migraine symptoms.
• Preventive treatment such as beta-blockers, tricyclic antidepressants or anti-epilepsy drugs. These treatments aim to reduce how often you have migraine attacks and how bad they are. You take them every day and build them up to an effective dose. Some people need to try a range of treatments, or may be referred to a specialist if the treatments don’t work for them.

Alongside the treatments many people benefit from reviewing whether lifestyle changes can help with their migraine attacks. This can include things like sticking to a routine, waking up at the same time each day, eating at similar times each day and staying hydrated. If there are factors such as alcohol or lack of sleep that seem to trigger your migraine attacks, there might be changes that you can make to help reduce how often you have attacks.