Migraine

Migraine With Aura - Symptoms, Phases, Risk Factors & Treatment

Migraine headaches cause recurrent headaches that can be debilitating. A migraine without aura is known as a common migraine while migraine with aura is called a classic migraine. Other symptoms that occur with migraines include nausea, vomiting, and sensitivity to light or sound. Only about 1/3 of those who suffer from migraines experience aura.

Aura usually is a warning sign of an impending migraine. It lasts anywhere from 5 minutes to 60 minutes. Aura can be difficult to distinguish from other neurologic conditions. Migraine with aura symptoms can be vague or difficult to describe. Aura can be experienced differently by everyone. Aura can occur without head pain and is more common in those over the age of 50.

Aura Migraine Symptoms

The symptoms of aura migraine include -

1. Visual disturbances are typically in the center of the field of vision spreading outward. This type of aura is most common.
   • Blind spots
   • Flashes
   • Zigzags
   • Stars
   • Losing sight temporarily for a short period of time
2. Sensory disturbances - numbness or tingling in the face, hands, fingers, or body
3. Speech or language difficulty - slurring words, mumbling, difficulty finding the right words
4. Muscle weakness

Phases of Migraines With Aura

There are 4 distinct phases of migraines with aura.

1. First phase is the prodromal phase - A precursor or the start of the attack.
2. Aura phase - Lasting 5-60 minutes
3. Headache phase - Lasts between 4 to 72 hours, with throbbing or pulsating pain on one side of the head. The pain is moderate to severe.
4. Postdrome or residual symptom phase - Also known as the “migraine hangover.” This phase can last a few hours to a full day after the headache goes away, symptoms include- feeling tired, unable to concentrate, general weakness, stiff neck, GI upset and nausea, and light sensitivity.

Shortening the length of a migraine attack is possible. If you know the symptoms you experience in the prodromal phase, you can take steps to limit the length of time the migraine will last.

• Drink plenty of fluids
• Avoid bright lights and noisy situations
• Limit activity/ sit in a quiet place
• Use relaxation techniques
• Apply ice to the head
• Massage head and neck

How to Prevent Migraine With Aura?

Avoiding an aura migraine can be difficult but there are some things you can do to decrease the risk of getting one. It is good to maintain consistent healthy lifestyle choices.

• Eat a healthy diet
• Good sleep habits are helpful
• Managing stress
• Exercise regularly
• Avoid migraine triggers

Aura Migraine Risk factors

Migraines are more common in women than men. They are also more common in those with a family history of migraines. Factors that lead to migraines or trigger them include:

• Certain foods - Aged cheese, Nitrates (found in hotdogs, and deli meats), Monosodium glutamate (MSG)
• High caffeine intake
• Withdrawal from coffee
• Weather changes - storm fronts, strong winds, or altitude changes
• Sleep disturbances
• Exposure to bright lights, loud noise, or strong odors
• Menstrual periods (hormonal changes)

Menstrual migraines are those that occur around the same time as their period. They can start between 2 days prior and 3 days after the flow starts. These are caused by a quick drop in estrogen levels. This type of migraine can be more severe, last longer, and cause greater light sensitivity than those that occur at other times or are not related to the menstrual cycle.

Migraine With Aura Treatment

Once symptoms of an oncoming migraine occur, acute treatment can be started. It is best to start at the prodromal phase. Oral medication can be taken. These include triptans and should be taken with anti-inflammatories (NSAIDS) medications such as ibuprofen or naproxen. Triptans are available in nasal form. Once in the middle of an attack, absorption of oral medications can be slowed and delay effects. Sumatriptan is available for injection and will provide relief within 10 minutes as it bypasses the digestive tract.

Treatment for Migraine Hangover

During the residual symptom phase, it is recommended you follow “headache hygiene.” This includes steps you can take to shorten your hangover phase. First, avoid the things that worsen your symptoms. For some, it is the blue light from computer or cell phone screens. Keep the lights dim and avoid loud noise. Light stretching or yoga can help. Some have a good response to caffeine intake. Ice, heat, or massage can help with relaxation.

It is a good idea to keep a headache diary. Include things such as your symptoms, prodromal, aura, details of pain, and what you feel during the postdrome phase. You can also include what type of interventions you tried to manage the migraine attack and whether they were helpful or not. Jot down any medications you took, when you took them, the dose and if they helped. Also, include any new symptoms you may have experienced with your migraine.

If you develop new symptoms that are not usual for you, call the doctor. These can be a sign of something other than a migraine.

 

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