What are the other Names for this Condition? (Also known as/Synonyms)

• Classic Migraine
• Complicated Migraine
• Migraine Headache with Aura

What is Migraine with Aura? (Definition/Background Information)

• Migraine headache is a chronic neurological disorder and the most common form of headache that is characterized by severe pounding and pain on one side of the head, which can last for several hours. It may be broadly classified into two types:
  • Migraine with Aura
  • Migraine without Aura
• Migraine with Aura is migraine headache that is preceded by a set of sensory or neurological disturbances that manifest commonly as bright dots, flashes and sparks, including numbness and tingling sensation, one-sided weakness, and dizziness
• The ‘aura’ is a temporary phenomenon and its typically onset between 20 to 60 minutes prior to a migraine attack. The condition is observed in about 1 in 3 individuals with migraines and is also variously referred to as Classic Migraine and Complicated Migraine
• Migraine without Aura is migraine headache that is not preceded by a set of sensory (visual) and neurological disturbances. It is important to explain to individuals with migraines this difference, since the aura serves as a warning sign about an impending migraine attack
• The exact cause of Migraine with Aura is not known, but women are more commonly affected than men. Certain trigger factors have been established for the condition that include food, stress, and a lack of sleep
• There are multiple medications, non-traditional techniques, and home remedies available for treating Migraine with Aura. The prognosis of the condition is generally good with appropriate treatment in most individuals

Who gets Migraine with Aura? (Age and Sex Distribution)

• Migraines are common in individuals of all age groups. Anywhere between 1 in 3-4 individuals with migraines may experience Migraine with Aura
• Adolescents and young adults are affected more than older adults; adults over the age of 50 years present fewer cases of migraine
• Migraine with Aura is more common in women than men; while boys report higher incidences than girls (prior to menarche)
• The condition is seen worldwide and no preference for any race or ethnicity is seen

What are the Risk Factors for Migraine with Aura? (Predisposing Factors)

The risk factors associated with Migraine with Aura may include:

• Family history of the condition
• Boys and girls in their teens are more at risk for migraines
• Hormonal changes: Women are likely to be affected by migraine headaches either before or after the onset of menstruation, pregnancy, and menopause, due to hormonal changes that occur in the body

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases one’s chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Migraine with Aura? (Etiology)

The exact cause for Migraine with Aura is not clearly established. The aura experienced is believed to be related to some abnormality with electrical signals being processed by the brain.

Some of the likely causes for migraines include:

• Dilatation of blood vessels in the brain
• Release of certain chemicals
• Presence of an excess amount of dopamine and serotonin; an unusual sensitivity of the blood vessels to dopamine and serotonin is noted

The following factors are known to trigger migraine headache attacks:

• Certain foods such as chocolate, cheese, nuts, alcohol, and monosodium glutamate (MSG, a food enhancer)
• Missing out on meals
• Physical and mental stress
• Use of birth-control pills
• Smoking
• Hormonal changes in women during their menstrual cycle

What are the Signs and Symptoms of Migraine with Aura?

The signs and symptoms of Migraine with Aura differ from one individual to another. These include:

• Changes in mood causing irritability, depression, and uncontrollable yawning
• Changes in sensation such as altered taste and smell
• Fatigue
• Pain on one side of the head; throbbing and severe pain
• Neck pain and stiffness
• Headache pain that may last from 4 hours to 72 hours
• Nausea and vomiting
• Individuals may observe increased sensitivity to sound and light
• Eating difficulties
• Difficulty in concentration
• Stomach upset
• Lethargy

The ‘aura’ may be perceived as any or all of the following symptoms (an hour before migraine headache onset):

• Visual symptoms such as seeing various shapes, bright spots, flashes of light, or zig-zag patterns
• Vision loss (temporary)
• Pins and needles sensation in the arms or legs
• Speech defects
• Hallucination
• Some individuals may find the ‘aura’ experience alarming and tend to believe that it forewarns them of a brain stroke or some other neurological condition

It is important to note that individuals who experience ‘aura’ during an attack of migraine may not experience the aura during a subsequent attack. It is difficult to predict in whom and when will such an experience occur.

How is Migraine with Aura Diagnosed?

The diagnosis of Migraine with Aura may include:

• Complete physical examination and assessment of signs and symptoms
• Thorough analysis of personal and family medical history
• Neurological examination by a qualified healthcare provider, if necessary
• Laboratory tests may be performed to rule out other causes of pain
• Computerized tomography (CT) scan of the head
• Magnetic resonance imaging (MRI) scan of the brain

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Migraine with Aura?

Migraine with Aura may lead to complications that include:

• Some headaches may be severe and last over 3 days
• Emotional and mental stress
• Poor performance at school or at work
• Recurrence of the condition
• Headaches due to medication overuse
• Low risk for brain stroke against a background of migraine attack
• Side effects of medication

How is Migraine with Aura Treated?

The following medications may be used in the treatment of Migraines with Aura:

• Pain-relieving medicines such as:
  • Ibuprofen and acetaminophen
  • Combination medication of acetaminophen, aspirin, and caffeine
  • Triptans and ergotamines
  • Anti-nausea medications
  • Opiates and other narcotics for severe pain
• Preventive medications such as:
  • Antidepressants
  • Cardiovascular drugs
  • Anti-seizure drugs
  • Botulinum toxin type A (Botox)

Preventive medications are prescribed when:

• There are two or more episodes of migraine headaches in a month
• If the pain-relievers are not effective
• When continued numbness and weakness is noted

Some of the non-traditional therapies that are used in treating Migraine with Aura include:

• Acupuncture
• Biofeedback (relaxation technique)
• Manual therapy involving massage and chiropractic treatments
• Use of vitamin and mineral supplements

Certain home care treatments may include:

• Muscle relaxation exercises including meditation, yoga, listening to music, and gardening
• Getting adequate sleep; while sleeping, resting in a dark quiet room
• Applying ice packs

How can Migraine with Aura be Prevented?

The prevention of Migraine with Aura involves bringing about some lifestyle changes that may include:

• Avoidance of triggers
• Reducing the effects of estrogen (for women)
• Having a stress-free routine with regular sleeping habits
• Regular exercise

What is the Prognosis of Migraine with Aura? (Outcomes/Resolutions)

The long term outlook of Migraine with Aura varies from one individual to another. It is generally good in a majority of individuals with adequate treatment.

• The aura usually fades away and no long-lasting after effects are noted. The migraine pain may subside with proper sleep and rest, even if no treatment is provided, in some individuals
• The acute attack of a migraine headache can be very discomforting, but with appropriate treatment most of the symptoms are manageable

Additional and Relevant Useful Information for Migraine with Aura:

The following DoveMed website link is a useful resource for additional information:

https://www.dovemed.com/health-topics/neurological-institute/