Persistent aura without infarction is a rare complication of migraine characterized by aura symptoms that persist for more than a week without evidence of a stroke or brain infarction on imaging. Auras typically involve reversible neurological disturbances that last between five and 60 minutes, but in this condition, they continue far longer (weeks or even years), and can be distressing and disruptive, affecting vision, and daily activities.
Symptoms of persistent aura are predominantly visual and may include:
- Seeing zigzags or flashes of light
- Visual hallucinations
- Temporary blind spots
- Blurry vision
However other neurological symptoms may also occur, such as:
- Tingling or numbness
- Speech difficulties
The underlying cause is thought to involve sustained hyperexcitability of the visual cortex, potentially linked to cortical spreading depression. This mechanism distinguishes persistent aura as a unique entity within the migraine spectrum.
In most cases, standard migraine treatments like triptans and ergot alkaloids are ineffective. However, some studies suggest that certain medications, such as lamotrigine (an anti-seizure medication) may be helpful.
Diagnosis requires confirming visual symptoms consistent with migraine aura that persist for at least a week and ruling out stroke or other conditions via CT or MRI.
If you experience an aura lasting longer than an hour consult your healthcare provider promptly. Early evaluation is essential to exclude more serious conditions, such as a stroke or retinal injury, and to determine the most appropriate treatment.