It is possible to have a migraine headache with auras or without an aura, although neither is less painful than the other. The biggest difference is that migraines without an aura may be less stressful and frightening. While migraines are often associated with auras, the reality is that only about twenty percent of sufferers actually experience any symptoms. The aura is all about distortions in perception.
The aura stage is part of the complex migraine, following the prodome stage. The aura stage usually lasts less than half an hour and its symptoms and effects can vary tremendously from one migraine sufferer to the next. Depending upon how extreme these symptoms get, the aura stage can become something quite horrifying, like a bad dream or, worse, a movie sequence of a bad dream.
Regardless of the connotation of an aura being a visual component, associated symptoms are not limited to visual distortions specifically. Additional characteristics can include:
- Blurred vision
- Flashing lights
- Wavy or zigzagging lines
- Spots or other shapes
- Blind spots or partial loss of sight
- Olfactory hallucinations, or the smelling of aromas that are not really there
- Tingling and/or numbness on the face or on the side, where the headache develops.
- Difficulty speaking or forming words
- Confusion
- Vertigo
- Partial and temporary paralysis
- Decrease in or loss of hearing
- Reduced sensation
- Hypersensitivity to feel and touch
The aura is caused by changes taking place within the outermost layer of the brain, the cortex.
With the depression of activity in the nerve cells, there is a resulting impairment in the function of the body part that is controlled by those cells. A slow spread in the depression of nerve cell activity is theorized to be the cause of the development of aura. The symptoms gradually build up and slowly make their way from one visual region or one body part to another.
For the migraine patient, this means the appearances of a black spot arising in his field of vision. Either flashing lights or bright lines that zig and zag back and forth may also encompass the black spot. Over a period of a few minutes, the black spot will slowly grow slightly larger. It is this unusual and often disturbing combination of a vision loss with accompanying flashing lights or zigzagging lines that distinguishes the typical migraine aura’s so-called “positive” symptoms.
The combination of so-called “negative symptoms” such as the loss of vision with the “positive symptoms” such as zigzagging lines make up the typically distinctive features of a migraine aura. The vision blackouts, the negative symptom, are caused by a depression of nerve activity. On the other hand, the zigzagging lines are caused by hyperactivity in the nerve cells. The origin of this sequence of neurological events leading to auras and headaches is still unknown. What is known, however, is that those suffering from migraines have been found to have an ingrained susceptibility to factors that generally are not headache triggers. In folks with migraine, changes in body chemistry, such as menstruation, certain foods, and dozens of environmental influences, such as a change in weather, may trigger an attack.
In order to be officially designated as a migraine headache with auras, the sufferer is required to have had at least two headaches with three out of four of the following:
- One or more aura symptoms that originated in the cerebral cortex or brain stem.
- At least one aura symptom that developed gradually over more than four minutes, or at least two or more aura symptoms occurring in succession.
- No single aura symptom that lasts for more than an hour. It is perfectly acceptable to have successive symptoms that extend that time, but each individual symptom should last no more than an hour.
- The headache itself may begin before, at the same time, or at an interval of no more than an hour after the hour.