Migraine attacks can be highly disruptive, often heralded by sensory disturbances known as aura. These auras, particularly visual ones like flashing lights, can be distressing and signal the onset of a headache, though they can occur without subsequent pain. This article provides information on recognizing, addressing, and potentially reducing the occurrence of these visual disturbances.
What Are Migraine Auras?
Migraine auras are neurological symptoms that typically precede or accompany a migraine headache. These disturbances affect approximately 25% to 30% of individuals who experience migraines. While various types of auras exist, visual auras are the most common, affecting about 90% of those who have aura.
Visual aura symptoms include flashing lights, brightly colored spots, zigzag lines, blind spots, shimmering effects, or a sensation of looking through water. These visual changes usually start gradually, evolving over several minutes, and typically resolve within 20 to 60 minutes.
The underlying mechanism for migraine aura is believed to involve cortical spreading depression. This is a slow wave of electrical and chemical activity that moves across the brain’s visual cortex, the area responsible for processing visual signals. As this wave spreads, it temporarily alters normal brain function, leading to the visual disturbances experienced during an aura. While visual auras are prominent, some people may also experience sensory auras, such as tingling or numbness, or less commonly, speech disturbances.
Responding When Flashing Lights Begin
When visual disturbances signal the start of a migraine aura, taking immediate action can help manage the episode. A first step is to seek a dark, quiet environment, as sensitivity to light and sound can intensify migraine symptoms. Resting in a calm space, perhaps by lying down, can also provide relief.
Applying a cold compress to the forehead or neck may offer a numbing effect that helps dull the discomfort. Some individuals find warm compresses or a warm shower beneficial for relaxing tense muscles. Maintaining adequate hydration by drinking water is also important, as dehydration can contribute to migraine.
For those who experience a headache following an aura, over-the-counter pain relievers like ibuprofen or acetaminophen can be taken early. Prescription medications, such as triptans (e.g., sumatriptan, zolmitriptan) or CGRP inhibitors (e.g., rimegepant, ubrogepant), can also be effective if taken at the first sign of symptoms, potentially shortening or alleviating the subsequent headache. Non-pharmacological techniques such as deep breathing or mindfulness can also help manage stress and discomfort during an aura.
Strategies to Reduce Future Occurrences
Reducing the frequency of migraine attacks, and thus aura, often involves identifying and avoiding personal triggers. Keeping a migraine diary can be a valuable tool to track potential triggers, such as specific foods, stress levels, sleep patterns, or environmental factors like bright lights or strong smells. Understanding these individual patterns allows for targeted avoidance strategies.
Lifestyle management plays a significant role in migraine prevention. Establishing a consistent sleep schedule, going to bed and waking up at the same time each day, can help regulate the body’s rhythms. Regular, moderate exercise, such as 30 to 50 minutes of aerobic activity three to five days a week, has been shown to reduce migraine frequency and severity. Practicing stress management techniques like yoga, meditation, or biofeedback can also lower the likelihood of attacks. Consistent meal times, a healthy diet, and adequate hydration are important, as skipping meals or dehydration can trigger migraines.
Preventive medications may be recommended if migraines are frequent or severe. These prescription options include beta-blockers (e.g., propranolol, metoprolol), anti-seizure drugs (e.g., topiramate), and certain antidepressants. Newer treatments, such as CGRP monoclonal antibodies (e.g., erenumab, fremanezumab) and gepants (e.g., atogepant), are also available for migraine prevention. Additionally, some complementary therapies like magnesium, riboflavin (vitamin B2), and CoQ10 have shown potential benefit; consult a doctor before taking any supplements.
When Professional Medical Advice is Needed
While migraine auras are generally not dangerous, certain symptoms or patterns warrant prompt medical evaluation. Seek medical advice if experiencing aura symptoms for the first time, or if they are unusual, differ significantly from previous experiences, or last longer than 60 minutes.
Immediate medical attention is necessary for a sudden, severe headache, often described as a “thunderclap” headache. Other concerning symptoms include headache accompanied by fever, a stiff neck, confusion, double vision, or weakness or numbness on one side of the body, as these could indicate a more serious underlying condition. If migraines are becoming more frequent or severe, significantly impacting daily life, or if over-the-counter remedies are no longer effective, consultation with a doctor is advised to discuss management strategies and potential preventive treatments.