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Anywhere between 40-60% of people with migraine experience subtle signs of an attack one to two days before its onset. During this time, known as the prodrome phase, they may experience any of an array of symptoms, including diarrhea, depression, constipation, irritability, and more.
However, for a smaller subset of migraine patients, a second phase brings more telling signals that a migraine is on its way: the migraine aura. In this post, we’ll demystify migraine aura, laying out what it is, symptoms, and some ways to stop or soothe an aura before it escalates into a migraine headache.
What is a migraine headache with aura?
A migraine headache with aura, often referred to as a classic migraine, is a headache that is chronically recurring. The headache often begins after or simultaneously with sensory disturbances that are known as aura. There are different types of migraine aura: the disturbances are often visual, but may also manifest as changes in sensory perception in the limbs or difficulty with verbal speech. About 30% of the 36 million patients who experience migraine headache pain nationwide also experience aura.
What are the types of migraine aura?
Visual Aura
Visual auras are the most common migraine aura. They are associated with temporary changes in vision that may consist of blind spots or loss of vision in one or both eyes (scotoma), as well as hallucinations such as zigzagging lines, floating dots, flashing lights, and geometric lines. One of the most well-known hallucinatory patterns, commonly referred to as the fortification spectrum, resembles the walls of a medieval fort.
Sensory Aura
Sensory aura is also common and may occur in addition to visual aura. It can also happen directly afterward or without any corresponding presence of visual aura at all. Sensory aura begins as tingling or a feeling of numbness in a limb that may travel up an arm over the course of 10 to 20 minutes. Sometimes, this sensation can even spread to the face and tongue, affecting one side.
Dysphasic Aura
This type of aura causes speech or language problems known as aphasia, which consists of difficulty forming, understanding, or tripping over words. Dysphasic aura may also present itself as garbled speech which sounds similar to that of someone who is inebriated, also referred to as dysarthria.
How long does migraine aura last?
A migraine aura typically lasts anywhere from five minutes to an hour and develops over a period of five to 20 minutes. In adults, an aura will generally occur prior to the migraine attack itself, but it’s possible for aura to occur in the midst of an attack. Children are more likely to experience an aura and an attack at the same time.
Is there a difference between migraine with aura and migraine without aura?
Despite the fact that migraine affects about 12% of the general population, our understanding of what causes auras before migraines is still lacking. For doctors and researchers, one of the most intriguing sources of potential answers comes from physiological differences between migraine that occurs with aura and migraine that occurs with no aura (a majority of migraine patients).
Observations suggest that migraine with aura may be hereditary, is more commonly associated with other health conditions, and is possibly the result of alterations in brain structure that may not share links to migraine without aura.
Can you have migraine aura with no pain?
Not all migraine auras occur with or are followed by headache or other pain. When a migraine aura occurs without corresponding pain, it’s generally known as an ocular migraine — a form of silent migraine. These types of migraines are referred to as silent migraines because of this absence of pain.
Are migraine auras dangerous?
Generally speaking, an aura associated with a migraine headache should recede within an hour. However, if an aura lasts longer than an hour, includes loss of vision in one eye, or causes severe weakness on one side of the body, it could be dangerous and potentially a warning sign for stroke. This is because both migraine and ischemic stroke are believed to be caused by hypoperfusion (reduced blood flow to the brain).
Still, migraine as a headache disorder is mostly benign. Since stress can act as a migraine trigger and even exacerbate symptoms (including anxiety), it’s best to remain calm and track symptoms. A significant majority of migraine auras aren’t a cause for worry beyond the temporary discomfort they can cause.
How to prevent migraines with aura
A majority of migraine patients report having triggers that precede the onset of a migraine attack. This means that knowing which migraine triggers lead to attacks has the potential to help prevent migraines with aura. One of the best ways to identify and avoid triggers that are specific to your experience is by using a migraine diary: a running journal of attacks, symptoms, pre-headache symptoms, severity, and more.
Some of the most common triggers include:
- Stress
- Too much or too little sleep
- Skipping Meals
- Certain foods
- Perfume
- Flickering Light
How to stop migraine aura (or at least soothe it)
Migraine aura treatment is generally the same as standard migraine treatment. Although migraine aura will generally go away on its own within an hour, there are actions you can take to soothe the intensity of the headache that may occur with or after it.
Turn off most lights and lower the shades.
Light commonly exacerbates the intensity of the headache. Seeking the relief of a dark room can ease the headache. At home, this means turning off the lights and drawing the shades or curtains. Since you may not always be at home during an attack, it can also help to keep dark, polarized sunglasses inside your car, bag, and office at work.
Turn on a narrow-band green light.
Research by Dr. Rami Burstein of Harvard University has found that most colors of light - white, blue, amber, and red - generate large electrical signals in the eye and brain that can worsen the migraine head pain via a newly discovered pathway that links vision to neurons in the brain that mediate the migraine. Dr. Burstein’s research also identified a specific, narrow band of green light that generates smaller electrical signals and soothes many of the more common migraine symptoms, including photophobia.
The Allay Lamp provides this specific narrow band of green light that migraine sufferers can turn to during the aura stage to soothe visual disturbances. It may reduce or terminate attacks, or even prevent a migraine headache.
Again, since you may not be home when a migraine headache with aura starts, taking the portable Allay lamp with you can let you take advantage of its soothing effects wherever you are at the time.
Knowledge is the key to managing a migraine aura or attack.
With a better understanding of the range of symptoms associated with migraine aura, the potential mechanisms within the brain that cause it, and ideas for both preventing and soothing it, patients will be better equipped to manage migraine from aura to headache. Every day, researchers are getting closer to a definitive physiological understanding of why migraine auras occur. This type of understanding, paired with groundbreaking treatments like narrow-band green light therapy, should give patients hope that there is indeed light at the end of the tunnel.
