Ask an expert: What is a migraine with aura?

Although many of us experience mild headaches from time to time, a migraine often brings with it more severe symptoms including nausea and sensitivity to light and noise. Flashing lights or disturbances to the normal vision can also occur shortly before a migraine which can be very distressing. In this expert guide, renowned consultant neurologist Dr Mark Weatherall, who is a leading specialist in the management of headaches, sheds light on the symptoms, causes and treatment of migraine with aura.

What is a migraine with aura?

Migraines are neurological events that are characterised predominantly by headache but can also have other symptoms, such as nausea as well as sensitivity to lights, noises and movement. Around a quarter of people who suffer from migraines also get an aura; a period of neurological dysfunction that usually occurs for a short period and is followed by the headache. This typically consists of visual disturbance in the form of a flashing light or a blind spot that may move or grow in the field of vision.

What are the symptoms?

For most people, migraine aura is visual. Patients typically experience glowing dots or zig zags that move across the field of vision for around fifteen to thirty minutes. Some people report sensory symptoms, such as a numbness or tingling which usually begins in the hand and slowly spreads up into the face. Occasionally, people also find that they can't get the right words out or they experience vertigo or dizziness with an aura migraine. In rare cases, some patients also report weakness in one side of the body.

What are the causes of migraine with aura?

Migraines are genetic and so people are born with a predisposition to experiencing them. Around a quarter of people who suffer from migraines also get aura. The aura processes happen on the surface of the brain in the form of a little wave of overactivity followed by a period of underactivity. This passes across the surface of the brain slowly and gives the patient the experience of visual disturbance or some of the other associated symptoms.

Although it is genes that predispose people to migraines, they may be triggered by things such as stress, lack of sleep or missing meals amongst others. Sometimes, however, the migraines will just come by themselves.

How are migraines with aura usually treated?

There is no way of treating the aura itself and so patients have to rest and let it pass. The headache of migraine, however, can be treated and many people will respond well to simple over the counter painkillers, such as paracetamol or anti-inflammatories. There are migraine specific painkillers, called Triptans, which can be prescribed by your doctor. Although these are very effective in treating the headache, the nausea and those symptoms, the aura has to be allowed to pass by itself.

Are migraines with aura dangerous?

Although migraines with aura aren’t dangerous, they can be disconcerting and quite frightening to experience, particularly if it is your first and you don't really understand what's going on. Migraine itself is not a particularly large risk for stroke or heart disease although it can be fed into calculations of a person's risk.

We know that having aura conveys a very tiny, increased chance of stroke, but this is dwarfed by the risks associated with smoking or having high blood pressure. If you have migraine with aura, the important thing is to live a normal, healthy life and to make sure that you don't smoke and that your blood pressure is under control so that any small risk that migraines may pose will melt into the background.

If you are struggling with migraines and wish to book a consultation with Dr Weatherall, you can do so by visiting his Top Doctors profile.