What is an aura migraine?

Migraine is a common condition that can often result in severe head pain and nausea. Some people may experience warning signs known as aura before a migraine attack begins.

The American Migraine Foundation suggests that aura is experienced by 25-30% of people with migraine.

Migraine typically occurs in 4 phases:

1. the prodromal phase
2. the aura phase
3. the headache phase
4. the postdromal phase

A migraine episode can last anywhere from several hours to several days, depending on the severity of the attack.

Read on to learn how to identify signs of aura before migraine, possible treatment methods, and how to prevent it.

Symptoms

The signs of aura before a migraine attack can include several different symptoms, such as visual, auditory, and motor symptoms.

Symptoms specific to each phase of aura migraine include:

Prodromal phrase

The prodromal phase is the first stage of migraine and can occur several hours or days before the actual migraine attack.

Symptoms can include:

• fatigue
• nausea
• neck pain
• sensitivity to light and sound
• muscle stiffness
• yawning
• mood changes, such as irritability

You may not always experience prodrome before a migraine attack. However, it may be helpful to keep a migraine diary to identify reoccurring symptoms, so you can treat them quickly when they do occur.

Aura phase

The aura phase can occur anywhere from 5 to 60 minutes before a migraine attack.

Symptoms can include:

• vision changes, such as seeing flickering or flashing lights, blind spots, and zig-zag patterns
• a tingling sensation in the hand, which can move up the arm and slowly begin to affect the face
• numbness
• difficulty speaking, which is relatively rare
• partial vision loss
• weakness on one side of the body

Some people may experience aura that does not result in migraine. This is also known as silent migraine.

Headache phase

The third phase is when head pain begins to develop and can last from several hours to several days.

Typically, the pain will begin on one side of the head and may later develop onto the other side or shift entirely.

Symptoms can include:

• nausea
• vomiting
• difficulty sleeping
• sensitivity to light and sound
• anxiety
• feeling panicked and overwhelmed by loud noises (phonophobia)

Postdromal phase

The final phase, also known as a migraine hangover, can last between 24 and 48 hours. The postdromal phase may not occur for everyone.

It can lead to symptoms such as:

• neck pain
• tiredness
• body aches and stiffness
• feeling thirsty
• fatigue
• brain fog

A 2016 study on the postdromal phase found that of 120 patients, just over 80% reported at least one non-headache symptom, such as difficulty concentrating and constipation.

What can trigger an attack?

The exact cause of migraine is still unknown. However, there are several factors that can trigger a migraine attack.

These include:

• stress
• eating certain foods
• not getting enough sleep
• hormonal changes — migraine is more likely to occur during your menstrual cycle
• bright lights
• anxiety and depression

Keeping a migraine diary can help you recognize what may be triggering your migraine episodes. This can allow you to put lifestyle measures into place and help decrease symptoms.

Treatment options

There are several treatment options that can help ease the symptoms of migraine. They include:

Medication

Various medications to help treat migraine are available in preventive and as-needed options.

Preventive treatment options include beta-blockers, such as atenolol (Tenormin) and antidepressants, such as Amitriptyline (Elavil).

As-needed treatment options include:

• triptans, such as sumatriptan (Imitrex) and naratriptan (Amerge)
• over-the-counter medications, such as ibuprofen (Advil) and acetaminophen (Tylenol)
• gepants (a type of calcitonin gene-related peptide (CGRP) inhibitor), such as ubrogepant (Ubrelvy) and rimegepant (Nurtec ODT).

Consider speaking with a healthcare professional to determine which medication may be best for you.

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Alternative therapies

Several alternative therapies can work to decrease symptoms of migraine with aura. Examples of therapies that can help include:

• Acupuncture: This is an ancient Chinese practice that involves the insertion of small needles into target areas of the body to help ease pain levels and any tension being held in the body.
• Aromatherapy: there are several plant-based oils that can help relieve symptoms of migraine, including lavender and peppermint oil.
• Biofeedback: This treatment method involves placing sensors on the body to develop an understanding of its overall functions and identify any health concerns.

It is important that you do not stop taking any medication without talking with a doctor first. Consider speaking to a doctor to discuss whether these options will be best for you.

How is aura migraine diagnosed?

The International Classification of Headache Disorders mentions that you will be diagnosed with aura migraine if you experience a minimum of two attacks fulfilling the below criteria: 

Have one or more of the following types of aura symptoms:

• visual
• sensory
• speech and/or language
• motor
• brainstem
• retinal

Have at least three of the following six characteristics of aura migraine:

• at least one symptom that develops slowly over the span of 5 minutes or more
• a minimum of two symptoms that occur one after the other
• each symptom lasts between 5 and 60 minutes
• a minimum of one symptom that occurs on one side of the body
• a minimum of one positive aura symptom, such as pins and needles
• a headache that develops alongside or within 60 minutes of aura

The aura migraine should also not be attributed to any other ICHD-3 condition.

Consider speaking with a healthcare professional if you think you may have aura migraine. They can help provide a diagnosis and suggest treatment plants that can help ease symptoms.

If you are experiencing any neurological symptoms, such as difficulty speaking, it is important to seek medical attention immediately. You will typically be evaluated for stroke or seizure first before migraine with aura is considered.

How can you prevent aura migraine?

There are many methods that can help prevent aura migraine, such as taking certain lifestyle measures to help decrease symptoms.

These include:

• ensuring that you get the right amount of sleep
• avoiding migraine-triggering food and drink, such as wine, cheese, and chocolate
• trying to decrease stress in your day-to-day life
• exercising regularly

Certain lifestyle measures can help lessen the chance of migraine re-occurring.

Summary

Migraine is a common condition that can sometimes be preceded by warning signs, also known as aura. Migraine with aura can lead to severe head pain, nausea, and fatigue.

There are several medication options that can help, such as over-the-counter pain relief or triptans.

Alternative therapies, such as acupuncture, aromatherapy, and biofeedback, may also help ease symptoms and provide relief.

If you are experiencing any neurological symptoms, such as difficulty speaking, it is important to seek medical attention immediately. You will typically be evaluated for stroke or seizure first before migraine with aura is considered.

If you find symptoms from migraine with aura are interfering with your day-to-day life, consider speaking with a healthcare professional who can help you identify the best treatment solutions.

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