Migraine aura is a distinct neurological phenomenon that can precede or accompany a migraine headache for certain individuals. It involves temporary sensory disturbances that signal the onset of a migraine attack. Understanding how to manage or prevent these auras can significantly improve the quality of life for those affected.
Understanding Migraine Aura
Migraine aura manifests as a range of temporary sensory disturbances, most commonly affecting vision. Visual auras often appear as flashing lights, shimmering zigzag lines, bright spots, or blind spots, which can gradually expand across the visual field.
Beyond visual disturbances, some individuals experience sensory auras, characterized by tingling or numbness that typically begins in one limb and slowly spreads, potentially affecting the face and tongue. Speech auras are less common but can involve difficulty finding words or slurred speech. These neurological symptoms usually develop gradually over about five minutes and typically resolve within 60 minutes. Aura symptoms are generally reversible and do not cause permanent brain damage.
Immediate Actions During Aura
Taking immediate action when an aura begins can help manage its severity or reduce the impact of the subsequent headache. Moving to a quiet, dark environment is often beneficial, as light and sound sensitivity can worsen migraine symptoms. Resting with closed eyes, perhaps even attempting to sleep, can provide relief. Applying a cold compress to the forehead or neck, or a warm compress to relax tense muscles, may also help.
Acute medications can be used at the first sign of an aura to potentially abort the migraine attack or lessen its intensity. Over-the-counter pain relievers such as ibuprofen, aspirin, or acetaminophen are often effective for mild to moderate symptoms. For more severe cases, prescription medications like triptans, which block pain pathways in the brain, can be prescribed by a doctor. Newer acute treatments, such as CGRP antagonists and ditans, are also available and work by targeting specific pain mechanisms. Anti-nausea medications may also be recommended, as they can help with associated symptoms and improve the absorption of other oral medications.
Long-Term Prevention of Aura
Proactive strategies can reduce the frequency and intensity of migraine auras over time. Identifying and avoiding individual triggers is a primary step in long-term prevention. Common triggers include stress, hormonal changes, certain foods, sleep disturbances (both too much and too little), bright lights, strong odors, and changes in weather. Keeping a migraine diary can help pinpoint these specific triggers.
Lifestyle modifications play a significant role in managing migraine aura. Establishing a regular sleep schedule, aiming for 7-9 hours of consistent sleep per night, helps stabilize the nervous system. Maintaining consistent meal times, staying well-hydrated, and avoiding skipping meals can prevent blood sugar fluctuations that may trigger migraines. Regular moderate exercise can reduce migraine frequency and severity. Stress management techniques, including meditation, deep breathing exercises, and yoga, are also beneficial for reducing overall migraine burden.
For individuals experiencing frequent or debilitating auras, a doctor might prescribe preventative medications. Common options include blood pressure-lowering medications (such as beta-blockers and calcium channel blockers), certain anti-seizure drugs, and antidepressants. Newer classes of preventative medications, including Calcitonin Gene-Related Peptide (CGRP) inhibitors, target specific pathways involved in migraine pain and are administered via injection. Botox injections can also help prevent chronic migraines in some adults.
When to Consult a Doctor
Seeking medical consultation is important for anyone experiencing migraine auras, especially if symptoms are new or unusual. It is important to consult a doctor immediately if aura symptoms are atypical, such as sudden onset, one-sided weakness, prolonged duration exceeding 60 minutes, or if it is the first time experiencing an aura. These symptoms can sometimes mimic other serious neurological conditions, including a stroke or transient ischemic attack (TIA).
A doctor can perform a proper diagnosis to rule out more severe underlying issues. Tests might include an eye examination, head CT scan, or MRI to assess brain structure and function. Conditions like hemiplegic migraine or migraine with brainstem aura require careful differentiation from stroke. Prompt medical evaluation ensures accurate diagnosis and appropriate management, especially if symptoms change significantly or occur for the first time later in life.