Besides a headache, typical migraine symptoms may include nausea, vomiting, and light sensitivity.
Some people can also experience visual or sensory disturbances during a migraine attack or before one starts. This is called an aura.
An aura is a collection of symptoms that occur before or along with a migraine attack. Auras can cause disturbances in your vision, sensation, or speech.
The American Migraine Foundation estimates that between 25 and 30 percent of people with migraine experience aura.
Because an aura can begin before a migraine attack starts, it can often be a warning sign that one is coming.
An aura typically begins about an hour before migraine pain starts and lasts less than 60 minutes. Not all migraine attacks involve an aura.
prodrome vs. aura
While an aura happens right before or during a migraine attack, the prodrome stage can start days before to indicate an attack is coming on. Prodrome symptoms might include fatigue, irritability, or neck pain.
An aura can cause a variety of different symptoms.
Visual auras are the most common type of aura. Some symptoms you may experience during a visual aura include:
- seeing jagged flashes of light, stars, or bright spots
- having zigzagging lines or geometric shapes in your field of vision
- partial vision loss or blind spots (scotomas)
Aura can also lead to changes in sensation. These symptoms can occur with or without a visual aura.
The main symptoms of a sensory aura are feelings of numbness or tingling, or a “pins and needles” sensation.
This tingling sensation may begin in one arm and travel upward. This feeling can also occur on one side of your face, lips, or tongue.
Speech and language symptoms
Disturbances in speech and language are less common aura symptoms. Symptoms may include:
- slurred speech
- not being able to form the right words
It’s not well understood what exactly causes an aura. It’s believed to be caused by a wave of electrical activity that spreads across the cortex of the brain.
This wave is then followed by a prolonged suppression of nerve cell activity. This can lead to various changes, such as changes in blood flow, which may lead to migraine symptoms.
It’s also possible that an aura may be triggered by the same things that can trigger migraine attacks without aura. These can include:
- stress or anxiety
- not getting enough sleep
- missing or having irregular meals
- consumption of alcohol or caffeine
- certain foods, such as chocolate, aged cheeses, and cured meats
- food additives like MSG or aspartame
- hormonal changes, such as during menstruation
- bright lights, strong smells, or loud noises
- vigorous exercise
- changes in the weather
- some medications
It’s possible for an aura to occur without a migraine headache. This is called silent migraine. Although the migraine pain doesn’t occur, the aura symptoms themselves can still be disruptive to daily activities.
Ocular migraine, a type of migraine attack characterized by visual symptoms, can sometimes occur without pain. Migraine with aura and retinal migraine are sometimes considered types of ocular migraine.
Migraine attacks that occur without pain may sometimes be diagnosed as transient ischemic attacks (TIAs) or seizures due to the symptoms being so similar.
There are several other types of migraine that involve neurological symptoms besides pain, such as:
- Migraine with brain stem aura. A rare type of migraine in which aura symptoms originate in the brain stem. Symptoms can include vertigo, ringing in the ears, and speech problems.
- Hemiplegic migraine. A migraine that occurs with an aura that includes one-sided weakness as well as numbness and tingling. It can occur with or without migraine pain.
- Vestibular migraine. A condition that includes sudden onset of vertigo, disorientation, and balance issues. Many people who experience vestibular migraine have no history of headaches.
- Retinal migraine. A type of migraine in which the aura causes you to lose vision in one eye.
You may also be diagnosed with chronic migraine if you experience migraine symptoms that occur 15 or more days in a month.
When aura symptoms begin, it can be helpful to move into a quiet, dark room and close your eyes.
Placing a cold compress on your forehead or the back of your neck may also help ease ensuing migraine pain.
Like other types of migraine, treating a migraine with aura involves a combination of medications. These include medications for both prevention and relief of symptoms.
Preventive medications that may stop migraine attacks from occurring include:
- antidepressants, such as amitriptyline
- blood pressure medications, like beta-blockers or calcium channel blockers
- anti-seizure drugs, such as topiramate
Medications for symptom relief help decrease the severity of an oncoming migraine attack. They’re typically taken as soon as the symptoms of an aura develop.
Examples of some of these medications are:
- over-the-counter pain relievers like acetaminophen (Tylenol) or ibuprofen (Motrin, Advil)
- triptans, such as rizatriptan and sumatriptan
- anti-nausea medications
If you haven’t had migraine with aura before and suddenly experience tingling or numbness on one side of your body, or slurred speech or difficulty talking, it’s important to get care right away.
Although these can be symptoms of a migraine aura, they can also be signs of a stroke. You’ll want to rule out the possibility of having a much more serious condition.
Additionally, seek emergency care for any headache that:
- comes on suddenly and severely
- is accompanied by a stiff neck, fever, or rash
- occurs with symptoms like confusion, convulsions, or loss of consciousness
- happens after a head injury
It’s also a good rule of thumb to make an appointment with your doctor for headaches that:
- happen frequently and last from hours to days
- disrupt your daily activities
- occur frequently when you used to be headache-free
Migraine can be disruptive and, in some cases, take a toll on your daily life. It can help to know that you’re not alone and that many other people are dealing with the same symptoms as you.
If you’re interested in finding migraine support and resources, there are a variety of apps that you can download, such as:
- Migraine Healthline. Receive migraine news and wellness information, and connect with others through live group chats or one-on-one conversations.
- Migraine Buddy. Track the specifics of your migraine attacks and share your experience with others in the Migraine Buddy community.
- Migraine Monitor. Track migraine symptoms while connecting with doctors and other people who are experiencing migraine.
- Migraine Insight. Enter information into a migraine journal and get an analysis and score for each potential migraine trigger.
A migraine aura is characterized by disturbances in your vision, sensation, or speech. It can occur before or during a migraine attack, and typically lasts less than 60 minutes.
Some people can have an aura without a migraine headache.
Migraine with aura can be treated with a combination of medications. Preventive medications may stop migraine symptoms from occurring, while other medications can help ease acute symptoms when they happen.
The symptoms of an aura can be similar to more serious conditions, like a stroke or seizure. If you haven’t experienced migraine with aura before and have numbness on one side of your body, or trouble with your speech, seek immediate medical attention.
It’s also important to get emergency care if you have a headache that’s severe, comes on suddenly, or is accompanied by a stiff neck, fever, confusion, or convulsions.