Understanding Complicated Migraines: Key Facts About Aura-Accompanied Migraines
Migraine with aura is a type of migraine characterized by temporary neurological symptoms that precede the onset of a headache. This condition, while common, can significantly impact quality of life for those affected.
Common Symptoms
The symptoms of migraine with aura primarily involve reversible neurological signs that develop gradually over several minutes and usually resolve within an hour. These symptoms often include visual disturbances such as zigzag lines, flashing lights, blind spots, or kaleidoscope-like patterns affecting both eyes or half of each eye’s visual field. Sensory changes like numbness, tingling (often beginning in one hand and moving up the arm), or pins-and-needles sensations are also common. Other symptoms may include speech difficulties or trouble finding words (aphasia), weakness on one side of the body, changes in smell, taste, or touch, brainstem-related symptoms including tinnitus, vertigo, double vision (diplopia), difficulty speaking (dysarthria), or decreased consciousness (though less common).
Common Triggers
Identifying and avoiding triggers can help reduce the risk of migraine with aura. Common triggers include hormonal changes, especially in women, stress and anxiety, certain foods and beverages (often including alcohol, caffeine, chocolate, and aged cheeses), changes in sleep patterns, environmental factors such as bright or flickering lights, and psychological factors including anxiety, depression, OCD, and ADHD-related stress.
Risk Factors
Risk factors for migraine with aura may include being female, being of certain ages, and having a family history of the condition. Women experience higher rates of migraine with aura compared to men. The frequency of migraine attacks can also increase the risk of chronic migraine. Ineffective treatment of acute attacks and medication overuse can worsen the condition, and there may be unique genetic or brainstem involvement in some cases.
Treatment Options
Treatment options for migraine with aura generally overlap with those for migraine without aura and include nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen for mild attacks, triptans (e.g., naratriptan), which are serotonin receptor agonists and effective at blocking migraine pain if taken early, calcitonin gene-related peptide (CGRP) receptor antagonists such as ubrogepant (Ubrelvy), serotonin agonists like lasmiditan (Reyvow), and preventive strategies focusing on trigger avoidance, lifestyle modifications, and sometimes prophylactic medications. Early treatment during the aura phase is often beneficial to mitigate the progression to headache.
Prevention and Management
Individuals should work with a healthcare professional to determine the best approach for preventing and managing their migraine with aura. This may involve lifestyle modifications such as maintaining a regular sleep schedule (aiming for at least 7-8 hours of sleep each night), stress management through exercise, yoga, or meditation, and identifying and avoiding triggers. In some cases, healthcare professionals may recommend complementary treatments such as acupuncture or relaxation techniques, and in more severe cases, medications to help manage the headache and other symptoms of migraine with aura.
If someone experiences frequent and severe migraine with aura, healthcare professionals may recommend preventive medications to reduce their frequency. It is also important to note that avoiding certain medications can help prevent migraine with aura.
Outlook
The outlook for people with migraine with aura can vary depending on the severity of the condition and how well they respond to treatment. Migraine with aura may be mild and infrequent for some people and severe and frequent for others, affecting their quality of life. With proper diagnosis and treatment, this type of migraine can be managed effectively.
However, immediate medical attention is warranted if aura symptoms last longer than one hour or present atypically, to rule out more serious conditions like stroke.
[1] Mayo Clinic. (2021). Migraine with aura. [online] Available at: https://www.mayoclinic.org/diseases-conditions/migraine-with-aura/symptoms-causes/syc-20353409
[2] National Health Service (NHS). (2021). Migraine with aura. [online] Available at: https://www.nhs.uk/conditions/migraine-with-aura/
[3] American Migraine Foundation. (2021). Migraine with Aura. [online] Available at: https://americanmigrainefoundation.org/resource-library/migraine-types/migraine-with-aura/
[4] American Migraine Foundation. (2021). Triggers and Risk Factors for Migraine with Aura. [online] Available at: https://americanmigrainefoundation.org/resource-library/migraine-types/migraine-with-aura/triggers-risk-factors/
[5] National Institute of Neurological Disorders and Stroke. (2021). Migraine Fact Sheet. [online] Available at: https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Migraine-Fact-Sheet
- The specific symptoms of migraine with aura can range from visual disturbances to sensory changes, speech difficulties, and brainstem-related symptoms, highlighting the impact this condition has on various aspects of health-and-wellness and mental-health.
- Quipta, a calcitonin gene-related peptide (CGRP) receptor antagonist like ubrogepant, is a treatment option for individuals experiencing migraine with aura, offering relief during acute attacks when taken early.
- Neurological-disorders, including migraine with aura, commonly affect women more than men, and hormonal changes, stress, and certain foods or beverages are among the common triggers that can exacerbate these conditions.
- Migraine with aura can significantly impact a person's quality of life due to symptoms such as visual disturbances and sensory changes, but with proper diagnosis, treatment, and management, it can be effectively managed.
- Symptoms lasting longer than one hour or presenting atypically can indicate more serious conditions like stroke, emphasizing the importance of immediate medical attention in such cases.
- In order to prevent and manage migraine with aura, a person may be advised to work closely with healthcare professionals to identify triggers, make lifestyle modifications, and consider complementary treatments or medications when necessary.
