Migraine with aura (also called classic migraine) is a recurring headache that strikes after or at the same time as sensory disturbances called aura. These disturbances can include flashes of light, blind spots and other vision changes or tingling in your hand or face.
Treatments for migraine with aura and migraine without aura (also called common migraine) are usually the same. You can try to prevent migraine with aura with the same medications and self-care measures used to prevent migraine.
Migraine aura symptoms include temporary visual or other disturbances that usually strike before other migraine symptoms — such as intense head pain, nausea, and sensitivity to light and sound.
Migraine aura usually occurs within an hour before head pain begins and generally lasts less than 60 minutes. Sometimes migraine aura occurs with little or no headache, especially in people age 50 and older.
Most people who have migraine with aura develop temporary visual signs and symptoms. which tend to start in the center of the field of vision and spread outward. These might include:
Other temporary disturbances sometimes associated with migraine aura include:
See your doctor immediately if you have the signs and symptoms of migraine with aura, such as temporary vision loss or floating spots or zigzag lines in your field of vision. Your doctor will need to rule out more-serious conditions, such as a stroke or retinal tear.
The cause of migraine with aura isn't entirely understood. There is evidence that the migraine with visual aura is like an electrical or chemical wave that moves across the part of your brain that processes visual signals (visual cortex) and causes these visual hallucinations.
Many of the same factors that trigger migraine can also trigger migraine with aura, including stress, bright lights, some foods and medications, too much or too little sleep, and menstruation.
Although no specific factors appear to increase the risk of migraine with aura, migraines in general seem to be more common in people with a family history of migraine. Migraines are also more common in women than in men.
People who have migraine with aura are at a mildly increased risk of stroke.
Your doctor might diagnose the migraine with aura based on your signs and symptoms, your medical and family history, and a physical exam. If your aura isn't followed by head pain or if the visual disturbances affect only one eye, your doctor might recommend certain tests to rule out more-serious conditions, such as a retinal tear or a TIA.
Assessments might include:
Your doctor might refer you to a doctor who specializes in nervous system disorders (neurologist) to rule out brain conditions that could be causing your symptoms.
For migraine with aura, just as with migraine alone, treatment is aimed at relieving migraine pain.
Medications used to relieve migraine pain work best when taken at the first sign of an oncoming migraine — as soon as signs and symptoms of a migraine aura begin. Depending on how severe your migraine pain is, types of medications that can be used to treat it include:
Pain relievers. These over-the-counter or prescription pain relievers include aspirin or ibuprofen (Advil, Motrin IB, others). When taken too long, these might cause medication-overuse headaches, and possibly ulcers and bleeding in the gastrointestinal tract.
Migraine relief medications that combine caffeine, aspirin and acetaminophen (Excedrin Migraine) may be helpful, but usually only against mild migraine pain.
Dihydroergotamines (D.H.E.45, Migranal). Available as a nasal spray or injection, these are most effective when taken shortly after the start of migraine symptoms for migraines that tend to last longer than 24 hours. Side effects can include worsening of migraine-related vomiting and nausea.
People with coronary artery disease, high blood pressure or kidney or liver disease should avoid dihydrogergotamines.
Medications can help prevent frequent migraines, with or without aura. Your doctor might recommend preventive medications if you have frequent, long-lasting or severe headaches that don't respond well to treatment.
Preventive medication is aimed at reducing how often you get a migraine headache with or without aura, how severe the attacks are, and how long they last. Options include:
When symptoms of migraine with aura start, try heading to a quiet, darkened room. Close your eyes and rest or take a nap. Place a cool cloth or an ice pack wrapped in a towel or cloth on your forehead or at the back of your neck.
Other practices that might soothe migraine with aura pain include:
If you're having temporary visual or sensory disturbances, see your family doctor. In some cases, you'll be referred to a doctor who specializes in nervous system disorders (neurologist).
Here's information to help you get ready for your appointment.
For migraine with aura, some questions to ask your doctor include:
Don't hesitate to ask other questions you have.
Your doctor is likely to ask you questions, including:
© 1998-2021 Mayo Foundation for Medical Education and Research (MFMER). All rights reserved.