About Migraines with Aura
The exact pathophysiologic causes of migraines with aura are not fully understood. However, some research suggests that a temporary disturbance in brain function, known as cortical spreading depression (CSD), may be linked to migraine with aura. CSD can disrupt the brain's electrical impulses and decrease blood flow to the part of the brain that processes visual signals.
Non-modifiable risk factors (factors a person cannot change or control) for migraines with aura include:
- Sex assigned at birth: Females are more likely than males to experience migraines with aura.
- Age: Migraines with aura are most common in individuals between puberty and their mid-to-late 30s.
- Family history: Having a family history of migraines, especially hemiplegic migraines, increases the risk.
Modifiable risk factors for migraines with aura include:
- Acute medication use/overuse
It's important to note that not everyone with these risk factors will experience migraines with aura, and migraines can also occur in individuals without any known risk factors. If you have concerns about your risk factors or experience migraines with aura, it's best to consult with a healthcare professional for personalized advice.
The most common early symptoms of migraines with aura include:
- Preheadache signs and symptoms known as prodrome, which can happen several hours to several days before a migraine attack and may include various symptoms like mood changes, food cravings, fatigue, and neck stiffness.
- Visual disturbances such as seeing flashes of light, spots, zigzag lines, or experiencing temporary vision loss.
- One-sided headache with nausea and sensitivity to light and sound.
As the migraine progresses or becomes more severe, other symptoms that may occur include:
- Continued aura symptoms throughout the headache stage or even without a headache.
- Neurological symptoms like sensory changes, vision changes, speech problems, and motor symptoms such as muscle weakness and difficulty balancing.
- Distorted vision such as blurred vision or loss of color vision.
Remember that individual experiences may vary. It's important to consult with a healthcare professional for an accurate diagnosis and appropriate management.
To diagnose migraine with aura, healthcare providers commonly perform the following examinations, tests, and procedures:
- Medical history review: Your doctor will ask about your symptoms and medical history.
- Physical examination: The doctor will look for physical signs of a medical problem and a detailed neurologic exam will be performed.
- Clinical diagnosis: Migraine with aura is usually diagnosed based on your symptoms and medical history.
To determine the stage or severity of migraine with aura, additional examinations, tests, and procedures may be recommended:
- Lab tests: Blood tests may be done to rule out other conditions.
- Imaging studies: CT scans or MRI scans can help evaluate the brain and rule out other causes of migraine.
- Transcranial Doppler ultrasonography: This test uses sound waves to evaluate blood flow in the brain.
Other examinations, test or procedures may be performed based on initial findings or individual factors. Remember, it's important to consult with your healthcare provider for personalized advice.
The goals of treatment for migraines with aura are to manage the headache pain, reduce the frequency and severity of migraine episodes, and improve overall quality of life. Here are the different treatment options and how they work:
Migraine Medications:
- Over-the-counter pain relief (e.g., acetaminophen, ibuprofen, naproxen) can help manage headache pain. Ask your doctor about appropriate dosing.
- Prescription migraine medications may be recommended by your healthcare professional to manage symptoms. These can include:
- Nonsteroidal anti-inflammatory drugs
- Calcitonin gene-related peptide (CGRP) receptor blockers (also called gepants)
- Ditans
- Prescription medications may be recommended to prevent migraines. They can include:
- Beta-blockers
- Antidepressants
- Anticonvulsants
- CGRP receptor antagonists – Both gepants and monoclonal antibodies
- Botulinum toxin type A.
Therapies:
- Physical therapy can be beneficial if paralysis or weakness occurs due to migraine with aura. It helps improve muscle strength and function.
Therapeutic procedures:
- Acupuncture and relaxation techniques are complementary treatments that may be recommended by healthcare professionals to help manage migraines with aura. They aim to reduce symptoms and promote relaxation.
Health behavior changes:
- Lifestyle modifications such as identifying triggers (e.g., stress, certain foods) and managing them can help prevent migraine episodes. Keeping a headache diary may be helpful in identifying triggers.
Clinical trials:
- Clinical trials are research studies that aim to evaluate new treatments for migraine. Participating in a clinical trial may provide access to innovative therapies that are not yet widely available. It is important to discuss clinical trial options with the healthcare team. They can review your individual situation and advise whether a clinical trial is an option to consider.
It's important to consult with your healthcare professional before starting any medication or treatment. They can provide personalized advice based on your individual situation. Remember, medication dosing may be affected by many factors. Check with your health care professional about dosing for your individual situation. Side effects can occur. Check with your health care professional or read the information provided with your medication for additional side effect information.