Migraine Aura: Symptoms, Diagnosis, Causes & Treatment

A migraine aura is often described as vision changes that cause small bright spots or blurring of the edges of the field of vision. This can last for 15 to 60 minutes, and is then followed by a very strong and constant headache.

In addition to the headache and visual sensations, migraine auras can also be associated with sensory changes, excessive sweating, nausea and difficulty speaking.

Migraine auras may not be associated with a specific trigger, and therefore they do not have a specific treatment. However, there are medications that can help to relieve symptoms and reduce the migraine, like acetaminophen or ibuprofen. It may also be necessary to change some eating or behavioral habits, such as getting enough sleep, as these factors can contribute to the onset of a migraine.

Common symptoms

The main symptoms of migraine auras are:

• Intense and constant headaches
• Visual changes, like flashes of light, dark spots or bright images
• Blurred vision or temporary loss of vision
• Dizziness or loss of balance
• Increased sensitivity to light and sounds
• Tingling in the head, lips, tongue, arms, hands or feet
• Sensation of noises in the ear
• Difficulty speaking or moving your eyes
• Excessive sweating
• Nausea or vomiting
• Hallucinations, such as a feeling of falling, or of objects being larger or smaller than they are in reality

Although a migraine aura is more common to occur before the migraine, it is possible to also experience visual symptoms during or after the migraine attack.

If episodes of the migraine aura are frequent, it is important to consult a general practitioner or neurologist so that a diagnosis can be confirmed and more targeted treatment can be started.

Is a migraine aura dangerous?

Despite being uncomfortable, the aura is not life-threatening. However, the frequent occurrence of migraine aura has been linked to an increased risk for depression, bipolar disorder and stroke, especially in women who use contraceptive pills, hormone replacement therapy or are smokers.

Online symptom checker

Migraine auras are usually associated with migraine headaches. Report your symptoms below if you suspect you may be expreriencing migraines:

This test is a guidance tool only. It is not intended to provide a diagnosis and does not replace a consultation with a neurologist or general practitioner.

Confirming a diagnosis

Migraine auras are confirmed by a a neurologist or general practitioner through the evaluation of symptoms, health history, family history and physical examination.

Additionally, the doctor may order imaging tests, such as MRI or CT scans, to rule out other conditions that may present with similar symptoms, such as a brain aneurysm or transient ischemic attack.

Possible causes

The causes of migraine auras are not yet well understood. One theory states that experiencing an aura that is followed by a migraine may be related to the narrowing of blood vessels in the brain.

The use of contraceptives can is associated with a higher risk for migraine auras, as these medications can trigger abnormalities in circulation. Migraine auras can also be caused by some foods and drinks (such as teas, soft drinks, coffee, citrus fruits, fried foods and fats), as well as sleeping more or less than usual or going too long without eating.

Why migraines improve during pregnancy

Migraine auras during pregnancy tend to decrease due to the consistent level of estrogen. This allows the vessels to dilate, which can prevent headaches. Women who experience migraine auras during pregnancy should consult their OB for the most appropriate treatment, which normally involves hormone replacement therapy. Read more about how headaches during pregnancy can be treated.

Treatment options

There is no specific treatment for migraine auras. There are several approaches to pain relief, which depend on the underlying cause of the migraine and the intensity of symptoms. You are advised to consult a neurologist,or a general practitioner to evaluate your individual case and initiate the most appropriate treatment.

Medications to relieve migraine pain work best when they are started as soon as the first sign of pain appears. Options your doctor may consider prescribing include: 

• Anti-inflammatories, such as ibuprofen or naproxen, and acetominophen: reduce the inflammatory effects on the membranes that cover the brain and also reduce the production of substances responsible for pain, most used in mild to moderate flare-ups;
• Triptans, such as sumatriptan or rizatriptan: these are normally the medicines with the best effect, as they reduce the production of substances responsible for pain, most used in moderate to severe and chronic flare-ups;
• Opioids, such as codeine: are only used in cases where treatment cannot be carried out with other medications or when the flare-ups are very intense and cannot be relieved with other medications;
• Antiemetics, such as metoclopramide or chlorpromazine: medicine for nausea and vomiting are used to relieve pain attacks when taken together with anti-inflammatories and triptans;
• Ergotamines, such as ergotamine or dihydroergotamine: help relieve acute migraine attacks with aura;
• Serotonin 5-HT1F receptor agonists, such as lasmiditan: to help relieve severe headache;
• Peptide antagonists related to the calcitonin gene, such as rimegepant: indicated if there is no improvement with other treatments.

In most cases, migraine medications are used in the form of tablets, however, there are also some in the form of a nasal spray, which have a faster effect.

These medications should only be used during flare-ups, as most can cause side effects when used for prolonged periods of time. For the prevention of flare-ups, you should opt for other types of medicine that are safer for longer uses.

Medicine to prevent migraines

The use of medication to prevent future migraine flare-ups are mainly used in cases where the migraine appears more than twice a month. Some examples of medications that can be used are:

• Tricyclic antidepressants, such as amitriptyline or nortriptyline;
• High blood pressure medication, such as propranolol, atenolol or metoprolol;
• Anticonvulsants, such as valproate, gabapentin or topiramate;
• Corticosteroids, such as dexamethasone;
• Humanized monoclonal antibodies, such as fremanezumab.

Injecting Botox into the muscles around the head can also helps prevent migraines in some people and may be recommended by your doctor.

Natural treatment options

In addition to the medical treatment recommended by your doctor, it is very important to maintain good daily habits, such as sleeping at least 7 hours, avoiding high-stress situations and exercising regularly.

Food can also play a role in reduce migraines and preventing flare-ups. It is important to avoid foods that normally lead to migraines, such as red wine, beer, onions, chocolate or processed meats. Additionally, supplementing with magnesium, vitamin B12 and coenzyme Q10 can also help to reduce migraines.

To complement this natural treatment, you can also prepare teas with specific medicinal plants that can help treat and prevent migraines.  Some teas include Tansy leaf tea (made with Tanacetum parthenium) or tea made with root of Petasites hybridus.