Aura occurs in about 20% of migraine sufferers. Some migraine sufferers have some headache attacks with aura and some without. An aura is a warning sign of migraine that usually occurs before the headache and can last 5-60 minutes, usually about 20 minutes.

Most commonly, auras consist of visual symptoms such as flashing lights, zigzag lines resembling forts (known as “fortification spectra”), or blind spots in your vision. The warnings may also distort figures, shapes and interfere with reading or driving. Some people get tingling, pins-and-needles sensations in one arm or leg (paresthesias). All of these are warnings, or aura, of migraine. Although these symptoms can be worrisome when first experienced, a person with aura often has similar occurrences each time. An older person with new onset aura, should consult their physician to make sure these are not symptoms of a TIA or stroke.

Even though the visual disturbance may seem to be in one eye, it is actually coming from the brain. Try covering one eye, then the other to see if there is some involvement of both eyes, indicating a source in the brain. Physicians and scientists now know that migraine aura is NOT due to lack of blood flow (ischemia) or constriction of the brain’s blood vessels. Instead, aura is produced by hyper-excited nerves in the brain that are activated prior to migraine pain. When the excited nerves are activated in the visual processing areas of the brain, the patient experiences visual symptoms. When other areas of the brain are excited, paresthesias may occur. Rarely is migraine aura associated with stroke; however, if you experience unusual or prolonged aura symptoms, immediately seek medical attention.

Did you know?
Lewis Carroll suffered with migraine with aura. His warning was a visual change or distortion of figures and shapes from which he got many of his ideas for the book Alice in Wonderland.

Some patients experience more generalized warnings of migraine such as personality changes, elation, or increases in energy or hunger. These warnings are referred to as prodromes of migraine and can precede a headache by hours to days. Prodromes are not the same thing as auras.

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