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EspañolMigraine with aura symptoms: What are the early signs of migraine with aura?
Overview: What does migraine with aura feel like?
Migraines are a headache disorder that causes severe headache pain, usually along one side of the head. People often experience other problems during a migraine attack, such as nausea, blurred vision, fatigue, tiredness, mood changes, problems thinking, and sensitivity to light and sound. Migraines with aura, or classic migraines, are a type of migraine where people experience vision changes and other neurological symptoms about five to 60 minutes before migraine pain kicks in.
Auras are caused by changes in the brain, for migraines always involve vision. Visual symptoms include flashes, bright lights, zigzags, haloes, perpendicular lines, blurry spots, or blind spots in the field of vision. Some people may lose their vision temporarily. There may be other sensory disturbances, including ear ringing, hearing noises that aren’t there, numbness, tingling, hallucinations, trouble talking, muscle weakness, and sensitivity to light, sound, or smell. A migraine with brainstem aura might have other debilitating aura symptoms such as double vision, dizziness, vertigo, loss of coordination, confusion, or loss of consciousness.
RELATED: What is migraine? Your guide to talking about the condition
Key takeaways:
Migraine with aura is a common health condition that can affect anyone regardless of age, sex, race, or ethnicity. Find updated migraine with aura statistics here.
Early signs of migraine with aura include prodromal symptoms, visual disturbances, vision loss, numbness, tingling, speech difficulties, hallucinations, and muscle weakness.
Serious migraine symptoms with aura, such as severe migraine symptoms, may require immediate medical attention.
Migraine with aura is caused by neurological disruptions that eventually evolve into nerve swelling and blood vessel constriction. You may be at risk for developing migraine with aura symptoms if you are female, middle-aged, drink too much alcohol, or have a family history of migraines.
Migraine with aura requires a medical diagnosis.
Migraine with aura generally requires treatment. Migraine with aura symptoms typically resolve with treatment, but not always. Migraine symptoms can be prevented by prescription medications, lifestyle changes, and avoiding migraine triggers.
Treating migraine with aura may include medications, pain relievers, preventive drugs, and lifestyle changes. Read more about migraine treatments here.
Untreated migraine with aura could result in complications like debilitating migraines, stroke, seizures, persistent aura, and disability.
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What are the early signs of migraine with aura?
The early signs of migraine with aura can occur in the first two stages of a migraine, the prodromal stage or the aura stage. Both stages are considered warning signs of an impending migraine headache.
Approximately 77% of people with migraines have prodromal symptoms 24 to 48 hours before other migraine symptoms. These include:
Frequent yawning
Mood changes (irritability, depression)
Frequent urination
Food cravings
Sluggishness
Restlessness
Sensitivity to light
Sensitivity to sound
Neck stiffness
Vision problems
Feeling cold
Sweating
Muscle stiffness
Difficulty speaking or reading
Nausea
Trouble sleeping
Fluid retention (edema)
Aura symptoms typically begin five to 60 minutes before a migraine headache, but sometimes occur during the headache. Aura symptoms include:
Blurring, bright lights, flashes of light, sparks, lines, haloes, zigzag lines, or blind spots (scotomas) in the visual field
Ringing in the ears (tinnitus)
Hearing noises
Numbness
Tingling
Temporary vision loss
Muscle weakness
Temporary reduction in hearing or sensation
Dizziness (migraine with brainstem aura)
Double vision (migraine with brainstem aura)
Poor coordination (migraine with brainstem aura)
RELATED: How long do migraines last?
Other migraine with aura symptoms
Migraines are headaches, so after the initial prodromal or aura symptoms, people will experience headaches and other symptoms. For some people, migraine aura is not followed by headache pain.
The headache phase of a migraine has symptoms such as:
Pulsing, throbbing, drilling, burning, or “icepick in the head” head pain usually on one side of the face and often increasing in the first few hours
Nausea
Vomiting
Sensitivity to light
Sensitivity to sound
Sensitivity to odors
Tears in the eyes
Runny nose
Pain in other parts of the body
Mood changes (depression or anxiety)
Neck pain or stiffness
Inability to concentrate
Migraine headache is often followed by a postdromal phase or “migraine hangover” caused by lingering problems with blood circulation. Symptoms last a day or two and include:
Fatigue
Dizziness
Trouble thinking or concentrating
Euphoria
Depression
RELATED: How to survive a migraine hangover
Migraine with aura vs. focal awareness seizures symptoms
Partial seizures, also called focal seizures, occur when neurons in one part of the brain fire uncontrollably. Partial seizures will have different symptoms depending on which part of the brain is affected. Some people with partial seizures will primarily have their vision affected, and others their sense of smell or hearing. Some may have sensations affected or their movement. Some may have their emotions or inhibitions affected. What focal seizures share in common with migraines is aura, which is another term for “simple focal seizures.” Simple focal seizures—also called focal awareness seizures—often precede a complex focal seizure (which involves loss of consciousness) or generalized seizure, so they function as auras, that is, as a warning stage of an upcoming seizure. Again, symptoms will vary depending on what part of the brain is affected. Though the symptoms may be similar, migraine auras are not seizures.
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Stages of migraine with aura: How can I tell which one I have?
The four stages of a migraine attack are prodrome, aura, headache, and postdrome. Prodromal and aura symptoms are warning signs of an oncoming migraine headache, but not everyone will go through these stages before the onset of migraine pain. The headache stage is marked by headache pain as well as other symptoms. After the headache passes, some people have a “migraine hangover” (postdrome migraine) where they still have lingering symptoms such as fatigue and depression.
The prodromal stage can last from a few hours to a few days. Only about 77% of people with migraines experience prodromal symptoms. Auras typically precede a full-blown headache by five minutes to 60 minutes. Auras are experienced by about 25% of people with migraines.
Migraine headaches typically last from four hours to three days. A migraine hangover is typically experienced for one or two days after an attack. Believe it or not, migraine headaches are only experienced by about 95% of people with migraines. The rest have a condition called migraine aura without headache or “silent migraine.” These people experience migraine auras during a migraine attack, but the aura does not evolve into a headache. In rare circumstances, some people experience auras for several days or months without an accompanying headache, a condition called persistent aura without infarction (PAWOI).
About 80% of people experience migraine hangovers, but they don’t necessarily happen after every migraine headache.
RELATED: What is a silent migraine?
When to see a doctor for migraine with aura symptoms
People with migraines will have to decide whether to see a doctor. It will depend on the frequency of attacks, the pain, and the degree of debilitation. According to the American Migraine Foundation, less than half of people with migraines seek medical help for their condition. In some ways, that’s too bad. Healthcare professionals have effective ways to prevent attacks and minimize symptoms during an attack.
Emergency room visits for migraine attacks are not uncommon. Some people may think they have a more serious problem like a stroke, transient ischemic attack (TIA), or “mini-stroke.”
If a person is diagnosed with a migraine, they will probably receive a Migraine Action Plan. The plan will instruct people to get urgent or emergency care in the following situations:
Severe nausea or vomiting
Inability to eat or drink
Experiencing a headache that is different from before
Experiencing symptoms that haven’t been experienced before, such as fever, seizures, weakness, vision loss, trouble walking, or trouble talking
A severely painful headache that does not respond to home treatment
A severe, persistent, or different type of headache in a woman who is pregnant
Clinicians diagnose migraines based on the symptoms and the history of attacks.
RELATED: When to talk to your doctor about a prescription for migraine
Complications of migraine with aura
Complications of migraine with aura include:
Persistent, long-lasting, and debilitating migraine attacks (status migrainosus)
Migraine aura-triggered seizures (migralepsy)
Migrainous stroke
Persistent aura (lasting a week or longer)
Disability
How to treat migraine with aura symptoms
Migraine treatment has two goals: relieving migraine attacks (acute treatment) and preventing migraine attacks (preventive treatment).
Triptans are the first-line acute treatment to relieve migraine symptoms, but over-the-counter NSAIDs such as ibuprofen can also be effective. Ergot drugs, lasmiditan, and anticonvulsants may also be prescribed.
Preventive medications aim to reduce the incidence of migraine attacks. Most are used only in people with chronic migraines, that is, people who have 15 or more migraine attacks per week. They may also be used in people with long-lasting, severely painful, or debilitating headaches. Preventive treatment is also appropriate for people who can’t use acute treatment drugs because they either don’t work or the side effects are intolerable. Preventive treatment options include beta blockers, antidepressants (such as amitriptyline), calcium channel blockers, and anticonvulsants. If these therapies don’t succeed, clinicians will use calcitonin gene-related peptide antagonists (CGRP inhibitors).
Living with migraine with aura
Migraine with aura is a chronic, if not lifelong, condition. That means people must take positive steps to manage the condition like any other chronic condition. Without taking any medications, there are numerous ways people can prevent migraine attacks:
Stay healthy: eat a healthy diet, exercise, and get plenty of sleep
Know your migraine triggers: keep a headache diary to identify possible triggers and then avoid those triggers
Avoid certain substances that can bring on or worsen migraines, like hormonal birth control, alcohol, and caffeine
Relax—stress is one of the most common triggers for migraines, so learn how to manage and reduce stress
Most importantly, get a diagnosis and a Migraine Action Plan
Migraine is a medical condition, so see a healthcare professional for a diagnosis, treatment, and medical advice. Most importantly, the neurologist or other healthcare professional will prepare a two-page Migraine Action Plan (MAP) for you. Read this plan in its entirety. The Home Rescue Plan will tell you what medications to take when you experience a migraine. The Hospital Rescue Plan will tell you when to go to urgent care or an emergency room. Bring the MAP with you when you go to a clinic or hospital. It has important instructions for the attending physician.
What’s next? Additional resources for people with migraine with aura symptoms
Test and diagnostics
International Classification of Headache Disorders 3, International Headache Society
Migraine headache, StatPearls
Treatments
Acute migraine headache: treatment strategies, American Family Physician
Migraine headache, StatPearls
Migraine medications and treatments, SingleCare
Your guide to the newest migraine medications, SingleCare
Scientific studies and clinical trials
Persistent negative visual aura in migraine without headache: a case study, Journal of Medical Case Reports
Prevalence and sex-ratio of the subtypes of migraine, International Journal of Epidemiology