What is the aura of a migraine?

The aura of a migraine attack is a set of symptoms medical professionals can use to differentiate other types of headaches from migraine episodes. However, not everyone who suffers from migraine attacks experiences auras.

Migraine aura 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. If your symptoms last longer or worsen, you should seek medical care.

Many migraine aura symptoms are alarming and can occur with or without headache pain. Although aura itself doesn’t usually indicate damage to the brain, it may serve as a warning sign that a migraine is about to occur or is in progress. There are common symptoms associated with migraine aura. Most people don't experience all of them, and their symptoms may change with each episode. Some of these symptoms may mimic other serious health conditions such as stroke or transient ischemic attack (TIA) and should be evaluated by a healthcare provider.

1. 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 attacks with aura, about 90% have vision disturbances. Some people experience blurred vision or blind spots in their field of vision. Temporary vision loss is also possible. Others report disturbances in their vision, such as seeing flashing dots, lights, sparkles, jagged lines or waves. 
2. Strange sensations/sensory changes: Aura often causes sensory symptoms, including numbness and/or tingling in the face, arm or leg. These symptoms aren’t permanent. 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.
3. Aural symptoms: During the aura phase of a migraine episode, changes in hearing, sensitivity to sound or other aural (hearing or ear-related) symptoms may occur. Hearing-related symptoms may also take the form of ringing in the ears, which is referred to as tinnitus.
4. Other symptoms: The aura of a migraine attack can alter other senses beyond touch, sight and hearing. Some people report smelling strange odors that aren’t there. Others report 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, aura may cause temporary paralysis on one side of the face or body. This type of migraine with aura is known as 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 migraine attacks. One theory is that an electrical or chemical wave spreads across certain parts of the brain (cortical spreading depression), resulting in symptoms.

No, not everyone experiences an aura with a migraine episode. 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 attack.

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

Many of the symptoms of 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. TIAs are serious and warrant medical attention. People who have TIAs have a higher risk of suffering from a serious stroke in the future. 

If you’ve already been diagnosed as having migraine 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.

Updated by Julie McDaniel, MSN, RN, CRNI, March 2025.