Types of Auras You May Experience During Migraine

For many, migraines are more than just severe headaches. They can come with a range of symptoms, including what’s known as a “migraine aura.” These sensory experiences can be unsettling, especially if you're unsure what's happening. Auras affect about 25-30% of people who experience migraines and often serve as a warning sign that a migraine is about to unfold.

What is a Migraine Aura?

A migraine aura is a reversible neurological disturbance that generally occurs before or during a migraine episode. While they’re often associated with visual changes, auras can affect other senses, motor function, and even cognition. These episodes last anywhere from five to 60 minutes and typically resolve before the headache phase begins, though not always.

Migraines with aura are distinct from migraines without aura and are classified as a specific subtype by medical professionals. While researchers continue to study the exact mechanisms behind auras, they are believed to occur due to a phenomenon called "cortical spreading depression." This wave of electrical activity spreads across the brain, temporarily affecting different regions and their corresponding functions.

Types of Auras You May Experience

Visual Aura

The most common type of migraine aura involves changes to your vision. These can range from mild disruptions to more dramatic visual phenomena. Symptoms may include:

• Scintillating scotomas: Zigzag patterns, often shimmering or flashing, that move across your field of vision.
• Blind spots (scotomas): Temporary loss of vision in specific areas.
• Blurred vision: Difficulty focusing or seeing clearly.
• Flashing lights: Bright spots or sparks of light, even in the dark.
• Tunnel vision: A narrowing of your field of vision.

Many people describe these symptoms as surreal, almost like looking through a kaleidoscope or frosted glass. While unsettling, visual auras are temporary and usually subside as the migraine progresses.

Sensory Aura

Sensory auras involve changes to your sense of touch or perception of physical sensations. These typically affect one side of the body and may include:

• Tingling or numbness: A feeling of "pins and needles," often beginning in the hand and moving up the arm to the face.
• Skin sensitivity: Heightened sensitivity to touch, which may feel uncomfortable or even painful.
• Temperature changes: A sudden sensation of warmth or cold spreading through a specific area.

Sensory auras can sometimes mimic or be mistaken for other conditions, such as a stroke. If you experience these symptoms for the first time, it is essential to consult a healthcare provider to rule out other causes.

Auditory Aura

Auditory auras are less common but can still significantly impact those who experience them. Symptoms may include:

• Hearing sounds that aren’t there (tinnitus): Such as ringing, buzzing, or whirring noises.
• Distorted hearing: Difficulty understanding sounds or perceiving them as muffled or altered.
• Auditory hallucinations: Uncommon but possible, where you may hear voices or music.

The exact mechanisms causing auditory auras remain under investigation, but they likely result from cortical spreading depression affecting areas of the brain responsible for auditory processing.

Motor Aura

Motor auras are rare and associated with hemiplegic migraines, a subtype that includes temporary weakness or paralysis. Symptoms may include:

• Weakness on one side of your body, which may make movement difficult.
• Loss of coordination or feeling unsteady, similar to vertigo.
• Drooping of facial muscles, resembling a stroke but reversible.

Motor auras can be alarming and are often indistinguishable from serious conditions like a transient ischemic attack (TIA). If you experience these symptoms for the first time, it is vital to get medical attention promptly.

Speech and Language Aura

Some migraines are accompanied by difficulties in communication, known as dysphasic or aphasic auras. Symptoms may include:

• Trouble finding words or expressing yourself clearly.
• Mixing up words or saying nonsensical phrases.
• Difficulty understanding speech, as if the spoken language suddenly becomes unfamiliar.

These symptoms can be confusing and distressing but are temporary. Keeping calm and waiting for the episode to pass is key, though it’s important to discuss these symptoms with your doctor.

Cognitive Aura

Cognitive auras involve changes in thinking and mental clarity. Symptoms may include:

• Mental fog or trouble concentrating.
• Memory lapses during the aura phase.
• Feelings of confusion, such as struggling to process your surroundings.

Cognitive auras are less studied but are reported by a subset of those who experience migraines with aura.

Olfactory and Gustatory Aura

Rarely, auras can affect your senses of smell and taste. Symptoms may include:

• Smelling phantom odors, such as burning, chemicals, or something pleasant.
• Altered taste perception, which may make certain foods or drinks seem unusual.

Olfactory auras are often misattributed to other conditions, but they are recognized as a part of the migraine spectrum.

Managing Migraine Auras

The unpredictability of migraine auras can feel frustrating, but there are ways to manage their impact on your daily life.

Keep a Migraine Journal

Documenting your auras, triggers, and symptoms can offer valuable insight for both you and your healthcare provider. Record details like the time of day, potential triggers, and how long the aura lasted.

Understand Your Triggers

Common triggers include stress, certain foods, sleep disruptions, and hormonal changes. Identifying and minimizing these triggers can help reduce the frequency of migraine attacks and the associated auras.

Create a Calm Environment

If you notice an aura beginning, find a quiet, dark space to rest. Reducing sensory stimulation can help minimize discomfort during the episode.

Talk to Your Doctor

Migraine with aura is treatable. Your healthcare provider can recommend a management plan tailored to your specific needs, which may involve medication, lifestyle changes, or other therapies.

Conclusion

Migraine auras can be challenging to live with, but understanding their types and triggers is an essential step toward better management. These sensory experiences, while often unsettling, are temporary and serve as a useful early warning system for many.

If you frequently experience auras or find them impacting your daily life, consult a healthcare professional. Together, you can explore strategies to manage their occurrence and reduce their impact, helping you regain control and improve your quality of life.