Aura is a sensory disturbance that can occur before a migraine headache. A person may see flashing lights, zigzag lines, or colored spots. In some cases, people experience aura without a headache. This is known as “silent migraine.”
According to the American Migraine Foundation, around 25–30% of people with migraine experience aura. The symptoms usually last anywhere from 5–60 minutes and can precede a headache or occur on their own.
This article will cover common questions surrounding the migraine aura experience, including how and whether symptoms are associated with headaches, what a silent migraine feels like, and more.
Yes, some people experience migraine aura without a headache. This is known as silent migraine. In the past, doctors called it acephalgic migraine.
Aura refers to a group of sensory disturbances that occur at the start of a migraine episode. These disturbances develop slowly over several minutes and can last 5–60 minutes in total. From this point, they usually fade away as the migraine headache begins.
However, in some cases, no headache develops. With silent migraine, a person may experience nausea, light sensitivity, and other migraine symptoms, but no pain.
It is important to note that the symptoms of silent migraine can overlap with the symptoms of a stroke. If a person has any of the following, seek immediate medical attention:
- sensory disturbances that occur suddenly
- aura that lasts more than 60 minutes or does not completely resolve
- weakness on one side of the body
- confusion or loss of consciousness
The symptoms of aura and silent migraine can vary from person to person, but may include:
Visual disturbances are the most common type of migraine aura, occurring in 98–99% of cases. A person with visual aura may see:
- colored or black spots
- flashing or flickering lights
- jagged or zigzag lines
- blurry or “foggy” images
Visual aura can also create temporary blind spots or a smaller field of vision.
Sensory disturbances, also known as paresthesias, are the next most common type of aura. They often occur at the same time as visual aura and can include:
- tingling or numbness
- pins and needles
- hearing noises that are not there
Speech or language problems
Disturbances to language and speech occur in 10% of migraine aura cases. A person with this type of aura may have difficulty forming the right words, slurred speech, or mumbled speech.
Migraine is a neurological condition that occurs due to a cascade of changes in the nervous system, particularly the brain.
- genetics, as migraine often runs in families
- chemical changes in the body
- environmental triggers
As this deterioration begins, some people experience aura. Scientists are not sure exactly why this happens, but it may result from cortical spreading depression (CSD). This phenomenon changes neuronal activity in the brain for a period of time.
If CSD can occur on its own, independently of the processes that cause a migraine headache, then this may explain why some people can experience aura without pain.
Treating migraine aura without a headache can be difficult, because often, the aura disappear on their own before medications have a chance to work. Some people may not require treatment if their symptoms are short-lived.
There may be more options for other migraine symptoms that last longer than aura, such as nausea or light sensitivity. Some people find it helps to take triptans or nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or aspirin.
However, scientists have not studied the effects of many medications on silent migraine. The Food and Drug Administration (FDA) has also not approved any drug for its treatment.
Until silent migraine passes, people may find it helpful to lie down in a cool, dark room and rest. It is a good idea not to drive or participate in other activities that could be dangerous if aura obscures a person’s vision.
People can also try to identify and avoid migraine triggers by keeping a migraine diary. Some examples of migraine triggers include:
If a person has frequent or recurrent aura episodes, they should speak with a neurologist. They can prescribe preventative medications to stop the symptoms.
Migraine aura are usually not an immediate cause for concern. While the symptoms can be distressing, they are temporary.
However, the migraine aura can resemble more serious conditions, such as a stroke. If a person has any of the following symptoms, call 911 or the number of the nearest emergency department:
- sudden numbness or weakness in the arms, legs, face, or down one side of the body
- sudden trouble seeing in one eye or both eyes
- sudden dizziness, difficulty walking, or loss of balance
- sudden difficulty speaking or understanding things
If someone experiences new or increasingly frequent aura episodes, they should also seek medical attention. This may indicate an underlying condition, such as:
- arterial emboli, or clots that hinder blood flow to an organ
- cardiac emboli, or occlusion of a brain blood vessel resulting from stroke
It is important to note that migraine aura appear to be a risk factor for other health conditions. According to a review in the British Medical Journal, ischemic stroke in people with migraine correlates with experiencing aura. Migraine aura is also associated with a higher risk for coronary heart disease.
People who experience aura can take steps to lower their risk for stroke and heart disease. This may mean stopping smoking, avoiding oral contraceptives that contain estrogen or seeking treatment for other risk factors, such as high cholesterol.
It is possible to develop migraine aura without a headache. People refer to this as “silent migraine.” The symptoms can include sensory disturbances, difficulty with speech, sensitivity to light or sound, and nausea or vomiting.
Migraine aura usually develop slowly and then fade away on their own. This sets them apart from a stroke, which can have similar symptoms but develop suddenly. If a person is in any doubt about the cause of their symptoms, they should seek immediate medical attention.