What is it?
A migraine with an aura is a very specific type of migraine that a small percent of migraine suffers experience. It is characterized as a debilitating migraine headache that is preceded by an aura. The aura refers to a range of symptoms or feelings you experience shortly before the onset of a migraine. They can include dizziness, sensitivity to light, ringing in your ears, and seeing zig zag lines. The onset of an aura is typically less than 30 minutes before the headache itself comes on. About 20% of migraines are categorized as migraines with an aura.
Scientists are not exactly sure what causes a migraine with aura but suspect it has to do with the brain chemicals serotonin and dopamine. Other suspected factors are genetics and obesity as well as certain environment, behavior or chemical triggers. In childhood, boys are more likely to experience a migraine. However, as adults women are more likely to be migraine sufferers.
The symptoms of a migraine with aura include:
- Low blood pressure
- Feeling hyper
- Sensitivity to light, sound or motion
- Dark circles under the eyes
Symptoms specific to the aura include:
- Blind spots or scotomas
- Hemianopsia (blindness in half your visual field)
- Fortification Spectra (seeing zig zag pattern)
- Scintilla (seeing flashing lights)
- Paresthesia (feeling prickling skin)
- Hallucinations (seeing things that aren’t actually there)
To determine a correct diagnosis, your doctor will perform a series of physical and neurological tests. Your doctor will also need to know your medical history to make an informed diagnosis. Additional testing, including blood tests and imaging, may be required to rule out other factors.
The treatment of migraines with an aura revolves around two purposes, relieving your current symptoms and preventing future attacks.
There are many available treatment options for a migraine with aura, ranging from medications to lifestyle changes. A magnetic device that has shown promising results is also available.
The following are possible treatments your doctor may recommend to relieve existing symptoms:
- Take a pain-relieving medication (i.e. aspirin or acetaminophen)
- Use non-steroidal anti-inflammatory medication
- Lie down in a quiet, dark room.
- Place a cold compresses on the areas of pain
- Take prescription medications
- Use drugs to treat related symptoms such as nausea and vomiting.
- Use the Cerena Transcranial Magnetic Stimulator (TMS), a prescription device placed on the back of the head at the onset of a migraine with aura.
To prevent future attacks, your doctor will likely suggest a combination of medication and identifying triggers. There have been very positive results for preventing migraine using medications that were originally intended for other purposes. These include:
- Beta-blockers such as Tenormin (atenolol), Inderal (propranolol), and Blocadren (timolol)
- Antidepressants such as Elavil (amitriptyline) and Pamelor (nortriptyline)
- Ergot derivatives such as Sansert (methysergide)
- Antihistamines such as Periactin (cyproheptadine)
- Anticonvulsants such as Depakene and Depakote (valproic acid)
Other prevention options include:
- Cefaly – an FDA approved headband-like device that transmits electrical impulses to the forehead
- Keeping a headache diary
- Avoid food triggers
- Avoid medication triggers
- Remove psychological triggers
- Minimize physical triggers
- Identify environmental triggers