What You Need To Know About Migraine Aura

“A migraine is a moderate or severe recurring headache that’s often throbbing, made worse by activity and experienced either all over the head or more on one side. Symptoms include nausea and sickness, and sensitivity to light and sound. Migraine with aura is a less common form of migraine – symptoms include visual disturbances of flashing lights or blind spots, tingling in the face or limbs, and sometimes memory or speech disturbance. These symptoms usually occur before the headache starts.” – Dr Bal Athwal, consultant neurologist at The Wellington Hospital 

“Around one in three people who suffer from migraines experience migraines with aura. There are very specific warning signs, including flashes of light, blind spots, and other changes in vision, or tingling in your hands or face. It is also possible to suffer from a migraine aura without a headache – you can experience flashes of light, for example, but a headache doesn’t always develop.” – Dr Elizabeth Rogers, associate clinical director at Bupa Health Clinics 

“The most common aura symptoms include temporary visual disturbances, such as blind spots, zigzag lines that gradually float across your field of vision, shimmering spots or starts, or vision loss and flashes of light. Migraine aura symptoms usually start and evolve gradually and tend to subside over the course of an hour or so.” – Bal

“Triggers for migraine vary for everyone, although some people find migraine auras come on due to stress, tiredness, or after eating certain foods and drinks. You may also find your period triggers a migraine aura. It’s not known exactly what causes them, but it’s believed they are caused by temporary changes in the chemicals, nerves and blood vessels in the brain.” – Elizabeth

“Changes in hormone levels, in particular oestrogen and progesterone, can cause headaches, including migraine auras. The degree to which the hormone levels shift (not the change itself) determines how severe migraines are. It seems migraines linked to menstruation are triggered by the drop in oestrogen experienced just before the onset of the bleed. Aura migraines, however, can occur at any time throughout the cycle and may be more associated with higher levels of oestrogen (around ovulation). Why migraine aura occurs for some women and not others is still under debate, but studies suggest it may be related to the ability of the liver to metabolise oestrogen, as well as the health of your gut – if you have gut issues like constipation or an imbalance in your gut bacteria, this can lead to oestrogen being reabsorbed back into the body, thus raising circulating levels.” – Dr Elisabeth Philipps, clinical neuroscientist

“Oral contraceptives may induce a de novo migraine (with or without an aura) in women without a previous history of the disease, worsen an existing migraine, or change the pattern of a previous existing migraine. HRT can also trigger migraine attacks in women without a history of migraine. Remember no migraine is ‘normal’ and you should not have to put up with migraine aura if you suspect the pill is to blame. Chat to your GP if you are concerned – they may be able to help with changing medications (a reduced oestrogen contraception may lower the incidence of migraine aura) or hormone tests to ascertain any imbalances.” – Elisabeth 

“If you experience migraine aura when taking the pill, you should switch to another form of contraception. Safer options include the progesterone-only pill, copper coil (IUD), Mirena coil (IUS), the implant or condoms.” – Dr Sam Brown, GP at The Bronte Clinic

“Although they’re uncomfortable, they generally aren’t serious. However, some symptoms are very similar to more serious health conditions – including a stroke – so it’s always important to seek medical care if you are worried.” – Elizabeth

“If you’re experiencing signs of a migraine aura, over-the-counter painkillers can relieve your symptoms. There are also prescribed medications that can help, so chat to your GP. During an attack, many people find that sleeping or lying in a darkened room also helps. Treating migraine aura without headache, however, can be tricky. Since many medications take longer to work than an aura’s duration, some people don’t take anything. Others, however, may find that symptoms like nausea and sensitivity to light and sound will improve if treated.” – Elizabeth 

“All migraine medication works best when taken at the first sign of a migraine starting. The severity of your pain and symptoms will determine what type of medication you should take. As well as standard painkillers such as aspirin or ibuprofen, triptans can also help. Triptans is the name given to a category of migraine-specific medicine – Sumatriptan is an example.” – Bal

“Unfortunately, migraine auras can’t be prevented completely, but there are supplements and medications you can take that may reduce the length, frequency and severity of attacks. For example, high-dose nutritional supplements like magnesium, CoQ10 and riboflavin can help, while preventative medicine such as propranolol or amitriptyline can be taken daily to suppress the tendency for migraine attacks to occur.” – Bal

“If you’re prone to hormonal migraine auras then avoiding stress, getting into a regular sleep pattern and eating small, frequent snacks can help. It could also be worth cutting back on alcohol, caffeine and processed foods, all of which tax the liver, limiting its ability to detoxify and excrete waste oestrogen. If this oestrogen builds up, it could trigger a migraine aura. Some studies show that addressing hormone balance and gut and liver health through diet can also help.” – Elisabeth

“To be eligible for Botox injections, you must have headaches for 15 or more days each month, with migraine headaches being on at least eight of these. You must have also tried at least three other medications to prevent migraine before this treatment is prescribed for you. Different NHS trusts have slightly different teams or services who can help, but you will need a referral from your GP to a specific headache team before you can even be considered for Botox treatment, as there are also other treatments available, depending on your condition. Some trusts also run community based headache clinics – start by speaking with your GP about the best pathway to access the right treatment for you in your area. If you are considering treatment for migraine auras, or migraines in general, it’s worth keeping a migraine diary to track your symptoms, which you can share with your GP to track migraines and how they develop.” – Bal

“A headache diary can include information on a range of things, however, it’s often best to keep it simple and record basic information. This can include the date and time of your attack as well as how long it lasted and its severity – you can record the severity on a scale from one to ten, where ten is the worst pain you can imagine. Also, note any other symptoms you experience alongside the headache, such as dizziness, vertigo, sensitivity to light, sound, smells or any symptoms that affect your movement (e.g. numbness); medication you may be taking; and anything else that may be helpful, such as potential triggers or your period. The Migraine Trust website has a helpful migraine diary template.” – Bal 

“If you have had migraine with aura but the nature of your headaches changes, it’s always best see your doctor. This may include a change in the frequency or severity of your headaches, the sudden onset of a headache, positional headaches, headaches initiated by exertion, constant headaches or any neurological signs.” – Sam

For more information, visit HCAHealthcare.co.uk, DrElisabethPhilipps.com, Bupa.co.uk and TheBronteClinic.com.