The term aura refers to a set of sensory disturbances that can develop before migraine, though some people have aura without migraine or a headache.
Migraine is a disabling neurological condition that results from a complex neuroinflammatory process. Migraine impacts at least 39 million people living in the United States. However, the true number of people living with migraine is likely much higher, as many people never receive a proper diagnosis.
This article discusses what migraine aura is, the causes, and whether auras are dangerous. It also looks at treatment and prevention methods.
Migraine aura is a series of sensory disturbances that typically precedes migraine, so people often refer to it as a “warning sign” for migraine. Symptoms associated with migraine aura include:
- seeing spots, stars, wavy lines, zigzags, flashes, bright dots, or black patches
- total temporary loss of vision
- slurred speech, trouble using words properly, or trouble speaking clearly
- tingling or numbness on one side of the body or in the face or hands
- weakness on one side of the body
Visual symptoms associated with aura tend to develop in the center of vision, move outwards, and always impact both eyes. Visual symptoms of aura also tend to change during the first 5 minutes someone experiences them.
Around 25–30% of people with migraine sometimes experience aura, and it typically lasts for around 20–60 minutes. People who experience aura with migraine tend not to develop aura before every migraine episode but tend to experience it once or twice annually.
According to American Migraine Foundation (AMF), some 4% of people with migraine experience aura without developing other symptoms associated with migraine. The AMF states that it generally affects people in their 20s and 30s or those aged 40–60.
People who have aura without migraine usually experienced aura with migraine in the past but grew out of the migraine phase as they got older. For some people who experience aura without migraine, symptoms may be severe or even last for days.
In most cases, aura is not dangerous. It is more of a nuisance or scary event rather than an actual danger to people. Visual symptoms of aura can be dangerous if they cause someone to lose their balance, run into things, or have accidents during activities, such as cooking or driving. For some people, aura can also make it difficult or frustrating to try to communicate.
Aura can also be very frightening if it causes loss of vision or greatly impacts vision, especially if someone does not understand what is happening. They may think they have lost their vision permanently or are experiencing signs of another serious neurological condition, such as a brain tumor or stroke.
Can they lead to death?
Aura itself cannot kill someone. However, it can be life threatening if it causes someone to have an accident, especially while driving, cooking, or operating machinery. Stroke and some autoimmune conditions that can be fatal can cause persistent, unexplained aura not associated with migraine.
Aura without migraine can also be a sign of permanent vision problems or visual field defects.
To distinguish aura from other visual disturbances, the AMF recommends covering one eye and trying to look at or read something, then covering the other eye and repeating the task. True aura will cause the same or similar vision problems in both eyes.
Researchers once believed aura occurred due to the constriction of tiny blood vessels that bring oxygenated blood to specific regions of the brain, but it is actually related to temporary changes in the activity levels of certain nerve cells.
The precise cause of migraine is unknown, though genetics and environmental factors do seem to play some role in their development and severity. Some 70–80% of people with migraine have a family history of migraine.
Hormonal changes also seem to play a role in migraine, as women are three times more likely than men to experience migraine. Many people experience their first migraine attack around the time they begin menstruating, and people often experience migraine during their childbearing years.
Aura does not require specific treatment. Instead, people should treat the migraine episode itself.
When migraine is about to develop, or when it is occurring, people can take over-the-counter (OTC) pain relief or headache medications or take prescription medications designed for migraine.
Currently, the Food and Drug Administration (FDA) has approved three OTC medications for the treatment of migraine:
- Excedrin® Migraine
- Advil® Migraine
- Motrin® Migraine
People should take OTC or prescription migraine medications as soon as they realize symptoms are developing. The earlier someone takes acute treatments, the more likely it is to prevent a full-blown migraine attack.
People may also use special devices that stop or dull pain when experiencing migraine.
There are many steps a person can take to try and prevent migraine and migraine with aura from occurring, including:
- taking preventive medications
- using devices designed to prevent migraine
- physical or behavioral therapy
- making lifestyle changes
Avoiding, managing, or treating migraine triggers may also help prevent or reduce migraine and aura. Common migraine triggers include:
- difficulty maintaining sleep hygiene
- skipping meals
- hormonal changes
- changes in the weather
- concussions and traumatic brain injuries
- certain foods
- medications that cause blood vessels to dilate or swell
- using headache or pain relief medications too much
- bright or fluorescent lights
- excessive noise
- watching a lot of TV or looking at digital screens for a long time
Aura is typically not dangerous and does not require medical attention. That said, the AMF recommends seeking medical attention if symptoms develop rapidly, do not respond to treatment, or last longer than an hour.
Aura can also be a sign of serious conditions that require immediate medical attention, including stroke. Speak with a doctor if aura occurs alongside additional symptoms, such as changes in a person’s level of consciousness or alertness or weakness on one side of the body.
Aura is a set of sensory disturbances that can occur before migraine.
Aura is generally not dangerous and cannot cause death unless symptoms interfere with vision to the extent that someone falls or injures themselves.
Speak with a doctor if aura lasts longer than one hour, drastically worsens, or occurs alongside additional symptoms other than migraine.