How to Know if You Have Migraine with Aura [Updated]

Medical Review by Headache Specialist Dr. Zubair Ahmed

Ever experience strange smells that others don’t detect? Symptoms of an aura aren’t always bizarre visual experiences reminiscent of a Van Gogh painting or an LSD trip.

It’s essential you know which of the 7 Types of Migraine you have by getting an accurate diagnosis. Effective treatment depends on the correct diagnosis that a headache specialist or qualified doc can provide.

About 20% of people with Migraine have Migraine with aura (1). How do you know if you’re one of them? Read on to find out.


What Happens During a Migraine Aura?


Imagine you are sitting at your computer with a pile of work to go through. Suddenly, you feel a little ‘off.’

You can’t focus on your screen, so you rub your eyes. Then you then begin to see floaters and flashes of light. Thinking that you’ve had enough work for the day, you think about grabbing a coffee.

As you stand up, your vision goes black and you can’t see.

You feel tingling in your face and your right arm goes numb. You understandably panic and ask your coworker to help you. You think you might be having a stroke.

That’s what Migraine with aura can feel like: many of the same stroke symptoms, yet only temporary. Despite the fact that aura symptoms disappear, they can be incredibly disabling (and scary) while they’re happening.


Aura and the Brain


“Migraine is a disorder of the brain, and it’s a disorder not just of sensory attention,” said Dr. Peter Goadsby, Director of the NIHR-Wellcome Trust King’s Clinical Research Facility, and professor of Neurology at King’s College London to Migraine Again.

While the causes of Migraine aura are not fully understood, the Mayo Clinic reports that there may be an electrical or chemical cause within the brain (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4344793/. ‘>5).

The experience can be frightening, to say the least. Oftentimes, people think there is something dangerously wrong with them. They may even think they’re having a stroke.

Fortunately, aura symptoms clear up in less than an hour for most people.

Just as there are several types of Migraine, there is also more than one type of aura! And you don’t have to experience the headache phase to experience aura.

Typical Aura

A typical aura is the most common type. Typical auras are usually followed by a headache, but not always. A typical aura without headache (TAWH) is possible but rare. TAWH happens in only 3% of women and 1% of men with Migraine(https://americanmigrainefoundation.org/resource-library/basilar-type-migraines/’>9):

  • One-sided visual changes, numbness, and tingling of face and limbs
  • Slurred speech
  • Vertigo
  • Ear ringing or changes in hearing
  • Double vision
  • Uncoordinated muscle movement
  • Unsteadiness
  • Changes in cognition (decreased)

THE CHALLENGE OF DIAGNOSING MIGRAINE WITH AURA


Visual Aura with Migraine

Unfortunately for many people with Migraine, getting accurately diagnosed proves challenging. All too often, people present to their doctors with symptoms of Migraine only to be diagnosed with another condition.

In many cases Migraine is misdiagnosed as sinusitis, causing patients to miss out on proper Migraine treatment and relief (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4028747/.’>11).

With only 500 certified headache specialists to treat more than 39 million people with Migraine, the chances of being misdiagnosed by a primary care physician, ENT provider, gynecologist, or neurologist are high.

When Migraine is properly diagnosed, doctors use a classification system known as the International Classification of Headache Disorders or ICHD-3, to distinguish between different Migraine types.


TREATMENT FOR MIGRAINE WITH AURA


Once you’re correctly diagnosed with Migraine with aura, it’s essential to find a treatment that works for you. There is currently no treatment that specifically targets the aura phase of an attack.

Available treatments address symptoms of the attack as a whole and/or try to stop the attack entirely. Some medications and devices are FDA-approved for Migraine, others are approved for Migraine with aura, and some are approved for both.

Most people with Migraine treat their symptoms during an attack. If your attacks are frequent, it’s highly recommended to add preventive treatments to stop them before they strike.

Reduction in frequency and severity of Migraine attacks is the primary goal for prevention. However, when an attack strikes, you may need acute medication to treat it.

Be warned: not all Migraine medications are safe for everyone (12). It’s vital to talk to your headache specialist about the best plan for you.

Acute Medications include (https://www.mayoclinic.org/diseases-conditions/migraine-headache/diagnosis-treatment/drc-20360207’>14):

Non-Medicinal Treatments, for Acute use and Prevention, Include:


HOW TO COPE DURING THE AURA PHASE


migraine aura experience

Many people with Migraine find it difficult to cope emotionally and physically with Migraine attacks, especially if they happen during work or when driving.

Coping with an Aura at Work

Unfortunately, many people with Migraine do not get the support they need from employers when having a Migraine attack. That’s especially true for those who hide the fact that they get frequent Migraine attacks.

However, there are coping strategies that can help you in your work environment:

  • Be open with your employer about your Migraine attacks, starting with how you call in sick with a migraine
  • Know your rights, as well as your employer’s sick and paid time off policies
  • Learn how to manage work-related stress
  • Keep a log of medical appointments, absences, and communication in case it’s needed
  • Request appropriate and reasonable workplace accommodations

Coping with an Aura While Driving

Driving during an aura can be really scary, especially with visual symptoms. Aura symptoms can be minor, but if your aura comes with complete or partial vision loss, driving becomes dangerous.

If you find that Migraine with aura causes debilitating symptoms, speak with your physician to see if it is recommended that you drive. It’s also important to be sure there are no side effects from Migraine medications that would limit your ability to drive safely.

If you experience a Migraine aura while driving, getting to a safe place and getting help is essential. One way to quickly contact a loved one for help is to have voice prompts activated on your phone or car radio system. Some people may benefit from having an alert bracelet, necklace or car setting to call for immediate help.van gogh's migraine trees

van gogh's migraine trees


FAMOUS PEOPLE WHO HAVE MIGRAINE WITH AURA


Celebrities are not immune to the effects of Migraine with aura. A few notable Migraine with aura warriors include:

  • Author Lewis Carroll – Famous author of Through the Looking Glass and Alice’s Adventure’s in Wonderland, Lewis Carroll was a well-known person with Migraine. In fact, the size distortions that Alice experiences down the rabbit hole are thought to be related to Migraine and are now called “Alice in Wonderland Syndrome.”
  • Artist Vincent van Gogh – Art enthusiasts have speculated that the halos, swirling patterns, and colors of paintings like Starry Night and Trees in the Garden in Front of the Entrance to Saint-Paul Hospital (right) are representations of van Gogh’s Migraine auras.
  • Artist George Seurat- Famous French post-Impressionist artist George Seurat, well known for the artistic technique pointillism, is said to have experienced Migraine with aura. Some medical researchers even refer to scotoma, or scintillating aura, in Migraine as the Seurat Effect.
  • Actress and Singer Kristin Chenoweth – Migraine warrior, famed actress, and singer Kristin Chenoweth shares her experience with Migraine at the Migraine World Summit. She explains how knowing she wasn’t alone was sometimes the best medicine for dealing with a condition that is largely invisible and often stigmatized.

TIPS FOR MANAGING MIGRAINE WITH AURA


  • Confirm you have the right diagnosis. Bring a headache diary into your doctor and review ALL your symptoms, even the strange and seemingly unrelated ones. If you’re not confident with your diagnosis, it may be time to see a doctor who is more familiar with migraine or a headache specialist.
  • Act quickly. Think of the aura as your friendly tornado siren. If you know what to look and listen for, you can get to a safe place and sometimes abort an attack before the debilitating headache phase begins. That’ll save you money, time, and a lot of pain. It can allow you to treat early, which experts say is far more effective than waiting.
  • Alert others. Don’t be afraid to ask for help, especially with driving and navigating in public. Friends don’t let friends experience an aura alone. Have an alert plan if you feel an aura coming on, like sending a quick pre-formatted text with instructions to your three closest caregivers.
  • Re-evaluate your treatment plan. If you indeed have migraine with aura, it may not be wise for you to take medications that further elevate your risk of stroke. You and your doctor can create a treatment plan with lifestyle changes that limits your risks.

Once you recognize the symptoms of Migraine with aura, you can better manage Migraine and all the emotions it brings.

Comments? Do you experience any Migraine with Aura symptoms?

Image: Youtube

First published May 11, 2015 / Updated June 2019

  1. American Migraine Foundation. Migraine and Aura. (n.d.). Retrieved from https://americanmigrainefoundation.org/resource-library/migraine-and-aura/
  2. Mayo Clinic Staff. Migraine with Aura: Overview. (2019, May 30). Retrieved from https://www.mayoclinic.org/diseases-conditions/migraine-with-aura/symptoms-causes/syc-20352072
  3. American Migraine Foundation. Migraine and Aura. (n.d.). Retrieved from https://americanmigrainefoundation.org/resource-library/migraine-and-aura/
  4. American Migraine Foundation. Migraine and Aura. (n.d.). Retrieved from https://americanmigrainefoundation.org/resource-library/migraine-and-aura/
  5. He, Y., Li, Y., & Nie, Z. (2015). Typical aura without headache: a case report and review of the literature. Journal of medical case reports, 9, 40. doi:10.1186/s13256-014-0510-7. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4344793/.
  6. He, Y., Li, Y., & Nie, Z. (2015). Typical aura without headache: a case report and review of the literature. Journal of medical case reports, 9, 40. doi:10.1186/s13256-014-0510-7. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4344793/.
  7. American Migraine Foundation. Migraine and Aura. (n.d.). Retrieved from https://americanmigrainefoundation.org/resource-library/migraine-and-aura/
  8. American Migraine Foundation. Migraine and Aura. (n.d.). Retrieved from https://americanmigrainefoundation.org/resource-library/migraine-and-aura/
  9. Migraine with Brainstem Aura (Basilar-Type Migraine). (n.d.) Retrieved from https://americanmigrainefoundation.org/resource-library/basilar-type-migraines/
  10. Al-Hashel, J. Y., Ahmed, S. F., Alroughani, R., & Goadsby, P. J. (2013). Migraine misdiagnosis as sinusitis, a delay that can last for many years. The journal of headache and pain, 14(1), 97. doi:10.1186/1129-2377-14-97. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4028747/.
  11. Al-Hashel, J. Y., Ahmed, S. F., Alroughani, R., & Goadsby, P. J. (2013). Migraine misdiagnosis as sinusitis, a delay that can last for many years. The journal of headache and pain, 14(1), 97. doi:10.1186/1129-2377-14-97. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4028747/.
  12. American Migraine Foundation. Migraine and Aura. (n.d.). Retrieved from https://americanmigrainefoundation.org/resource-library/migraine-and-aura/
  13. Mayo Clinic Staff. Migraine: Diagnosis. (2019, May 31). Retrieved from https://www.mayoclinic.org/diseases-conditions/migraine-headache/diagnosis-treatment/drc-20360207
  14. Mayo Clinic Staff. Migraine: Diagnosis. (2019, May 31). Retrieved from https://www.mayoclinic.org/diseases-conditions/migraine-headache/diagnosis-treatment/drc-20360207
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