Migraine with Aura

Overview

Migraine with aura, also known as classic migraine, is a recurring headache that is often accompanied by sensory disturbances called aura. Aura symptoms can include visual disturbances such as flashes of light, blind spots, or zigzag lines, as well as tingling sensations in the hands or face. These disturbances usually occur before other migraine symptoms, such as intense head pain, nausea, and sensitivity to light and sound. Treatments for migraine with aura and migraine without aura are typically the same, including medications and self-care measures to prevent migraines. It is important to see a doctor immediately if you experience new signs and symptoms of migraine with aura, such as temporary vision loss, speech or language difficulty, or muscle weakness on one side of your body.

Understanding the disease

Symptoms

The symptoms of migraine with aura include temporary visual or other disturbances that usually occur before other migraine symptoms like intense head pain, nausea, and sensitivity to light and sound. These symptoms may include:

• Flashes of light
• Blind spots (scotomas)
• Zigzag lines that gradually float across your field of vision
• Shimmering spots or stars
• Changes in vision or vision loss
• Flashes of light Other temporary disturbances sometimes associated with migraine aura include numbness, tingling sensations, speech or language difficulty, and muscle weakness. It's important to see a doctor immediately if you experience new signs and symptoms of migraine with aura, such as temporary vision loss, speech or language difficulty, and muscle weakness on one side of your body. This could help rule out more-serious conditions like a stroke.

Risk Factors

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.

Development

Migraine with aura is believed to be caused by an electrical or chemical wave that moves across the brain. This wave determines the type of symptoms experienced during an aura. The most common type of aura is visual aura, which occurs when the wave moves through the visual cortex and causes visual disturbances. Other types of aura can involve sensory disturbances, speech and language problems, or muscle weakness, and they can occur in different regions of the brain. The specific symptoms a person experiences during a migraine with aura depend on which part of the brain is affected by the electrical or chemical wave.

Assessment and Diagnosis

Triage

You should see a doctor immediately if you experience new signs and symptoms of migraine with aura, such as temporary vision loss, speech or language difficulty, and muscle weakness on one side of your body. These symptoms may indicate a more serious condition like a stroke, and it's essential to rule out any potential health risks.

Diagnosis

Your doctor might diagnose 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, your doctor might recommend certain tests to rule out more-serious conditions, such as a transient ischemic attack (TIA). Assessments might include an eye examination, a head computerized tomography (CT) scan, and magnetic resonance imaging (MRI). 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.

Management and Treatment

Complications

Potential complications of migraine with aura include an increased risk of stroke. While the electrical and chemical waves associated with migraine aura do not cause harm to the brain, they can mimic symptoms of a stroke, and it is essential to see a doctor immediately if new signs and symptoms of migraine with aura occur, such as temporary vision loss, speech or language difficulty, and muscle weakness on one side of your body to rule out more serious conditions.

Prevention

Treatments for migraine with aura and migraine without aura are usually the same, and you can try to prevent migraine with aura with the same medications and self-care measures used to prevent migraine. These may include:

1. Identifying and avoiding triggers: Keeping a headache diary can help you identify your personal triggers, such as stress, certain foods, or lack of sleep. Once you know your triggers, you can take steps to avoid them.
2. Medications: Over-the-counter pain relievers, such as ibuprofen, acetaminophen, or aspirin, can help relieve migraine symptoms. Prescription medications, including triptans, anti-inflammatory drugs, and blood vessel wideners, may be recommended by your doctor for prevention or acute treatment.
3. Lifestyle modifications: Maintaining regular sleep patterns, reducing stress, and practicing relaxation techniques like deep breathing, meditation, or yoga can help prevent migraines.
4. Hydration: Drinking water throughout the day, especially during physical activity or in hot weather, can help prevent dehydration, which can trigger migraines in some people.
5. Dietary changes: Eliminating potential triggers, such as processed foods, food additives, or alcohol, and increasing consumption of fruits, vegetables, and whole grains may help prevent migraines in some individuals. Consult your doctor for personalized advice on how to prevent migraine with aura or other types of migraines.

Treatment

Migraine with aura treatments typically involve medications and self-care measures to prevent and manage symptoms. There isn't a specific treatment for migraine aura itself, but treatments for migraine with aura and migraine without aura (common migraine) are usually the same. Some options include:

1. Pain-relieving medications: Over-the-counter pain relievers such as ibuprofen, aspirin, or acetaminophen can help alleviate headache pain. Prescription medications like triptans, which constrict blood vessels in the brain, and anti-nausea medications can also be effective.
2. Preventive medications: Doctors may prescribe preventive medications for migraine patients who experience frequent and severe migraines. These medications can help reduce the frequency and severity of migraine attacks.
3. Lifestyle changes: Making lifestyle modifications can help prevent migraines and reduce their frequency. This may include maintaining regular sleep patterns, minimizing stress, avoiding trigger foods, and practicing relaxation techniques like deep breathing exercises or meditation.
4. Behavioral and relaxation therapies: Cognitive-behavioral therapy, stress management techniques, and relaxation exercises can help reduce stress and improve coping skills, which may help prevent migraines. It is essential to consult with a healthcare professional to determine the most appropriate treatment plan based on your specific symptoms and medical history.

Preparing for medical consultation

To prepare for an appointment for migraine with aura, you should:

1. Note down your symptoms: Make a list of the migraine symptoms you're experiencing, including the frequency, duration, severity, and any specific triggers.
2. Keep a headache diary: Ahead of the appointment, start keeping a headache diary to track the patterns of your migraines, including when they occur, how long they last, and the intensity of the pain.
3. List medications and supplements: Make a list of all prescription and over-the-counter medications, as well as vitamins and supplements, you're taking.
4. Bring a family member or friend: Consider bringing a friend or family member along to the appointment for support and to help remember the information discussed during the appointment.
5. Prepare questions: Write down a list of questions to ask your doctor about your condition, treatment options, and any concerns you have.
6. Be aware of pre-appointment restrictions: When scheduling the appointment, inquire about any preparations or tests required before the appointment. By being well-prepared and informative, you can make the most of your appointment and work with your doctor to develop an appropriate treatment plan for your migraine with aura.