Scientists still do not know the exact causes of migraine with aura, but they are aware of what typically triggers migraine. Some migraine triggers may include hormonal changes, dehydration, and caffeine.

Migraine is a condition often accompanied by symptoms such as nausea and light sensitivity.

However, according to the American Migraine Foundation, around 25–30% of people with migraine experience a variety of more extensive visual and sensory symptoms known collectively as an aura.

These symptoms may include flashes of light, blind spots, hallucinations, and an inability to speak clearly.

This article discusses why a person may have a sudden increase in migraine with aura and when they should contact a doctor.

Aura refers to a variety of visual, sensory, and speech disturbances that can occur with or without a headache. These usually last for 20–60 minutes but can sometimes last for several days.

According to a review in the Journal of Headache and Pain, a person experiencing migraine with aura may notice the following symptoms:

  • visual changes, such as seeing flashes of light, spots, or zigzag lines or experiencing a temporary loss of vision
  • sensory changes, such as numbness or tingling in arms, legs, fingers, or face
  • speech changes, such as difficulty finding words and garbled speech
  • weakness or difficulty moving the arms, legs, or face

Throughout a person’s life, both the number of times they experience migraine with aura and how they experience these episodes can change. A person may also notice that their symptoms of aura continue without accompanying headaches as they get older.

Many of the same factors that trigger migraine without aura can also cause migraine with aura. These potential causes include the following:

Environmental and genetic triggers

According to the Office of Women’s Health, some researchers believe that substances in the brain may build up and cause inflammation, leading to migraine.

Genes and environmental triggers may also play a role in this inflammation.

They also note that although migraine is more common in females, males are more likely to develop migraine with aura.

Brain function and blood flow

Some research suggests that a temporary disturbance in brain function, or cortical spreading depression (CSD), may be linked to migraine with aura.

CSD can disrupt the brain’s electrical impulses and, in turn, decrease blood flow to the part of the brain that deals with visual perception. However, scientists still do not fully understand why people with migraine with aura experience spontaneous CSD or how to prevent it.

One 2010 study also states that changes in blood flow to the brain may be the cause of migraine and stroke in certain people.

It is possible that a person who develops an increasing number of migraine with aura episodes may have experienced some change that affects blood flow to their brain.

Hormonal changes

Hormones, including estrogen, can play a role in how frequently a person may experience migraine. According to the Migraine Research Foundation, females are more likely than males to develop migraine.

However, after menopause, the number of migraine episodes that females experience tends to decrease.

As a result of changing hormone levels prior to menopause, the American Migraine Foundation indicate that some females may be more prone to migraine if they are more sensitive to hormonal changes.

Episodes can occur following pregnancy or prior to a period due to drops in hormone levels associated with these events.

Another study into the relationship between migraine and estrogen pointed out that the use of hormonal birth control may help prevent both headaches and aura in females during their reproductive years.

However, it is vital for people who experience migraine with aura episodes to discuss birth control options with a healthcare provider. Combination birth control pills, which contain estrogen, have been linked to a small increased risk of ischemic stroke in people who experience migraine with aura.

Progestin-only contraceptives are often a safer choice for individuals with migraine with aura.

Underlying medical conditions

If a person first experiences migraine-like symptoms after the age of 60 years, an underlying condition may be responsible. Likewise, if new medical conditions occur, they could affect both the triggers and treatment of a person’s migraine.

Some underlying conditions associated with migraine include:

  • high blood pressure
  • heart disease
  • atherosclerosis, which occurs when the arteries harden
  • diabetes
  • stroke

If one or more of these conditions triggers migraine with aura, treating that condition may help prevent future migraine episodes.

New or worsening triggers

People can also have different sensitivities to their environment that could cause migraine symptoms to increase in frequency over time.

There are several common triggers that a person may become more sensitive to or experience more frequently. According to the American Migraine Foundation, some common migraine triggers include:

  • stress
  • changes in routine
  • caffeine
  • changes in sleep
  • hormonal changes
  • changes in the environment, such as exposure to bright light
  • alcohol consumption
  • changes in diet
  • dehydration
  • overusing medications
  • certain smells

Exposure to new potential triggers or changes in habits could cause more frequent and sudden migraine with aura episodes.

It is important for a person to keep a record of their headaches and symptoms to help identify possible new triggers that may be causing the episodes to occur.

It may not always be possible to prevent chronic migraine, but there are some steps a person can take to help reduce their severity or duration.

For example, research indicates that most treatment plans should include avoiding known triggers and taking preventive medications as prescribed.

Some other things a person can do to help prevent episodes include:

  • making certain changes to their diet to include more healthful foods and avoid processed foods
  • limiting caffeine and alcohol intake
  • practicing activities and exercises that encourage relaxation, such as deep breathing and yoga
  • maintaining a consistent sleep routine

When a person begins experiencing aura symptoms, it can be helpful to move into a quiet, dark room and close the eyes. Placing a cold compress on the forehead or the back of the neck may also help ease migraine pain.

There are three main areas of treatment for migraine with aura. These are as follows:

  • lifestyle and trigger management
  • acute treatments, such as medications to stop a migraine episode while it is happening or reduce its severity or duration
    • These include analgesics, nonsteroidal anti-inflammatory drugs, gepants, and ditans.
  • preventive treatments, such as medications designed to prevent migraine episodes from starting and reduce their frequency and severity
    • These include CGRP antagonists, beta-blockers, antidepressants, anticonvulsants, and Botulinum toxin type A.

According to the American Migraine Foundation, a person needs emergency medical care if there is an immediate onset of symptoms or the symptoms do not go away within 60 minutes.

Also, someone should contact the person’s doctor as soon as possible if they experience symptoms such as weakness on one side of the body or changes in alertness. Migraine increases a person’s risk factors for stroke, so a doctor will need to evaluate any symptoms related to stroke.

A person should also talk with their doctor if they find that their medication is no longer working. This could be due to an increase in symptoms, a change in other medications, or the onset of side effects from their other medications.

Before starting or stopping any medication, a person should talk with their doctor.

Migraine with aura can get worse for several reasons. These can include changes in other medical conditions, triggers, or hormones.

A person should talk with their doctor if they notice that their symptoms are changing, becoming more severe, or increasing in frequency.