What is the aura of a migraine?

The aura of a migraine is a set of symptoms medical professionals can use to differentiate headaches from migraines, though not everyone who suffers from migraines experiences auras. Understanding what an aura is can help you determine if you're experiencing this type of migraine so you can decide if it's time to talk to your medical provider.

The term aura of a migraine refers to sensory, motor and speech symptoms that occur shortly before or at the start of a migraine headache. The symptoms usually come on suddenly and persist for 10 minutes to an hour.

Many migraine aura symptoms are alarming. However, an aura doesn't indicate damage to the brain, but rather can serve as a warning sign that a migraine is about to occur or is in progress. The following are common symptoms associated with migraine aura. Most people don't experience all of them, and their symptoms may change with each episode.

Vision disturbances

Changes in vision may occur during the aura of a migraine. Visual aura is the most common type of aura. Of those who experience migraine with aura, about 90% have vision disturbances. Some people experience blurred vision or blind spots in their field of vision, and temporary vision loss is also possible. Others report disturbances in their vision, such as seeing flashing dots, lights, sparkles, jagged lines or waves.

Strange sensations

Auras often cause sensory symptoms, including numbness and/or tingling in the face, arm or leg. These symptoms aren’t permanent, and the typical duration is five to 60 minutes. The migraine headache generally occurs within 60 minutes of sensory symptoms. Typically, the sensory symptoms travel or migrate from the face to the arms and legs.

Aural symptoms

During the aura phase of a migraine, changes in hearing or aural symptoms may occur. Most often, hearing-related symptoms take the form of ringing in the ears, which medical providers refer to as tinnitus.

Other symptoms

The aura of a migraine can alter other senses beyond touch, sight and hearing. Some people report strange odors or a reduction in sense of smell. Migraine sufferers may also experience changes in taste.

In some cases, the ability to speak becomes temporarily impaired. A person may be unable to remember certain words, or they may be unable to speak. Slurred speech may also occur.

Rarely, auras cause temporary paralysis on one side of the face or body. This type of migraine with aura is known as a hemiplegic migraine.

There is still much that we don't understand about migraines. At this time, research has yet to provide a definitive answer for why auras can occur with some migraines. One theory is that an electrical or chemical wave spreads across certain parts of the brain, resulting in symptoms.

No, not everyone experiences an aura with a migraine. Many migraine sufferers don't report any aura symptoms. In fact, only 15% to 25% of those who suffer from migraines have an accompanying aura. Even people who have had an accompanying aura may not develop one every time that they get a migraine.

Yes, you can get a migraine aura without head pain. Some people develop an aura but don't experience the headache phase of the migraine afterward. This is known as an acephalgic migraine, and it’s commonly called a silent migraine.

Many of the symptoms of an aura are similar to those of transient ischemic attacks (TIAs).  That’s why it’s important to see your healthcare provider if you’re experiencing these symptoms, as it may indicate something more serious. TIA is serious and warrants medical attention. People who have TIAs are more at risk for having a serious stroke in the future. 

If you've already been diagnosed as having migraines with aura, let your medical provider know if the symptoms interfere with your daily life. Also, be sure to report any new aura symptoms. Work with your provider to find the right over-the-counter migraine medications or prescription treatments for you.

Published January 2023.