Migraine Aura: Not Just What You See

There’s a good reason why many people think of visual symptoms when they think of “migraine aura”. It’s very common!

If one in six people have a migraine attack sometime in their lives, one or two of those people are likely to experience migraine aura, and that most likely includes a visual element – flashing lights, patterns, spirals – click here for more interesting descriptions of the visual aura phenomenon.

But a study published last month reminds us that aura is not always visual. This particular study took 272 patients who had migraine with aura – that is, according to the IHS classification, “Recurrent attacks, lasting minutes, of unilateral fully-reversible visual, sensory or other central nervous system symptoms that usually develop gradually and are usually followed by headache and associated migraine symptoms.”

So among this group, just how common were the various aura symptoms?

As you might guess, visual aura was by far the most common at 96.3%.

But the interesting thing was that many patients experience more than one kind of aura (though not necessarily at the same time).

Next was sensory aura – also very common among aura patients, at 33.1%. Sensory refers mostly to “paresthesia”, which is a feeling of numbness or a pricking sensation – “pins and needles”.

Unlike visual aura, which, of course, you “see”, sensory aura can be in different parts of the body. Most often it was felt in an arm or on one side of the face, but it may also be in a leg or even the tongue.

Almost as common was speech and/or language aura, at 25.6%. This includes an inability to name objects or recognize names (anomia), and less commonly actual difficulty in speaking, resulting in slurred speech (dysarthria).

More rare but still significant was motor aura at 1.8%. It’s hard to draw too many conclusions with such a small group in the study, but this would include paralysis or weakness, in this case in one or two arms.

More common was a type of aura associated with a particular kind of migraine – brainstem aura. Migraine formerly known as “basilar migraine”, migraine with brainstem aura may include various kinds of aura, such as vertigo, speech/language aura, double vision, even a reduced level of consciousness (get an overview of migraine with brainstem aura here).

Brainstem aura was reported in 8.5% of these patients.

One of the most interesting aspects of this study was that patients reported relapses – that is, 13% of patients noted that their aura symptoms returned within 24 hours.

Although the study did talk about typical treatments, it would be interesting to do a further study on which treatments were most effective for various kinds of aura (if there is any difference in effectiveness). There is still a lot of disagreement about what tends to work best.

Your turn! Leave a comment – which of these have you experienced? Are there other migraine symptoms that you have noticed? Do you have more than one kind of aura at the same time, or during the same attack?