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Migraine is more than just a headache — it’s a neurological condition. While intense headaches are a main feature of migraine attacks, there are also many other symptoms that can occur. One of these symptoms is aura.

An aura is a set of symptoms that can occur before or during a migraine episode. It can cause problems with vision, sensation, or speech, and usually lasts about 20 to 60 minutes.

The American Migraine Foundation estimates that about 25 to 30 percent of people with migraine experience aura. It can be a warning sign that a migraine attack is coming, or it can happen during an attack. It doesn’t happen with every migraine episode.

Knowing more about migraine auras can help you identify one as soon as possible, take any medications, and prepare for the migraine attack.

Visual aura is an aura with visual symptoms. This is the most common kind, occurring in 90 to 99 percent of migraine auras. Besides being the most common kind, these auras are also the most varied, with many different and complex symptoms reported.

Common characteristics of visual aura can include:

  • flashes of bright light
  • “foggy” vision
  • zigzag lines
  • blind spots
  • small bright dots
  • feeling like you’re seeing things through heat waves or water
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An aura describes symptoms that often proceed a migraine and can include visual changes, flashes of light, and even numbness in hands and face. Illustration by Wenzdai Figueroa.

Sensory auras involve sensory disturbances. This type of aura is present in approximately 36 percent of migraine auras. These sensory disturbances can happen with or without a visual aura.

The main symptoms of a sensory aura include:

  • feelings of numbness or tingling
  • a “pins and needles” sensation

The tingling can happen in one arm and then travel up to one side of the face, lips, or tongue.

A dysphasic aura is an aura that involves speech and language disturbances. This occurs in about 10 percent of migraine auras.

Symptoms can include:

  • slurred speech
  • mumbling
  • not being able to form the right words

Along with aura, there are many other symptoms that can accompany migraine attacks. These can vary depending on the stage or phase of the migraine, as well as among individuals and for each attack.

Prodrome

The prodrome stage is also called the premonitory phase. It can last a few hours or even several days. Most people living with migraine will have prodrome but perhaps not with every migraine attack. During prodrome, taking any medications, avoiding known triggers, and trying relaxation techniques may help to prevent the headache.

Each person is different, but common prodrome symptoms can include:

Aura

Symptoms of aura usually develop over at least 5 minutes and can last up to 1 hour, although in approximately 20 percent of people, the aura can last even longer. Some people experience aura not before the headache phase, but after the headache has started.

Symptoms of aura can include:

  • seeing bright spots or flashes of light
  • vision loss or dark spots
  • tingling in an arm or leg, similar to “pins and needles”
  • trouble speaking
  • ringing in the ears

Headache

The headache phase is the one most people probably think of when they think of migraine. This phase is marked by pain on one or both sides of the head. It can last anywhere from a few hours to up to 3 days. Headaches can vary from person to person and for each individual attack.

In addition to the head pain, symptoms can include:

  • high sensitivity to light, sounds, or smells
  • nausea or vomiting
  • abdominal pain or heartburn
  • loss of appetite
  • blurred vision
  • lightheadedness
  • fainting
  • worsening pain with physical activity

Postdrome

The postdrome phase is also called the “migraine hangover.” It comes after the headache phase, but not everyone with migraine has postdrome. Approximately 80 percent of people living with migraine experience it. It may not occur with every migraine attack.

Symptoms of postdrome can include:

  • fatigue
  • body aches
  • trouble concentrating
  • sensitivity to light
  • dizziness

If your headache or migraine attacks are interfering with your everyday life or functioning, see a doctor. If you have migraine with aura, treatment with a combination of acute and preventative medication is necessary.

A doctor can do an exam and determine whether the cause is migraine or something else. An accurate diagnosis can help you get appropriate treatment.

Medical attention is necessary if your symptoms:

  • have a sudden onset
  • last more than an hour
  • don’t completely resolve
Medical emergency

If you have symptoms like a loss of consciousness or weakness on one side of the body, call 911 or go to the nearest emergency room. Migraine with aura increases the risk of stroke, and it’s important to avoid certain medications and treat any symptoms.

Not everyone living with migraine has migraine with aura. Even for those who have migraine with aura, there can be a lot of variation. You may not have aura with each migraine attack, and the symptoms can vary. Auras can be visual, sensory, or dysphasic.

Knowing the symptoms of each can help you describe them to a doctor and get appropriate treatment.