Migraine with aura, also called classic migraine, has all the symptoms of common migraine, with an additional phase before the headache where many strange symptoms are experienced. Aura symptoms are usually one of the senses not working quite right (for example numbness or pins and needles, seeing colours or flashing lights, strange tastes). Visual aura is so common it can also be called ocular migraine.

The definition of an aura is a recurrent attack that features temporary visual, sensory and/or speech/language symptoms. These symptoms include:

• blurry vision
• light sensitivity
• vision loss
• seeing zigzags or squiggly lines
• numbness
• tingling
• weakness
• confusion
• difficulty speaking
• dizziness
• diarrhea
• vomiting
• abdominal pain

The more serious migraine subtypes – brainstem, hemiplegic, vestibular, abdominal, and retinal migraine – are all variants of migraine with aura. They can also occur with or without headache.

Managing aura can be difficult, as there aren’t really any treatments for aura. Many medications like triptans usually take longer to work than aura’s duration, so most people don’t take any as-needed medication. Others, however, may find that associated symptoms like nausea and sensitivity to light and sound will improve if treated. 

Some small studies and case reports suggest the use of magnesium and aspirin may be helpful, or for people with prolonged aura, there have been some treatment attempts with intranasal ketamine. These, however, are very small studies, and this is very much an off-label use. There are few specific studies looking at CGRP and aura, but anecdotally many have found the CGRP preventatives prevent the entire attack, including aura, so may be a worthwhile consideration.

Read more about migraine with aura from the Migraine Trust or the American Migraine Foundation.