Migraine with Aura: A Plain-Language Guide to the Warning Signs, Causes, and Treatment Options
Updated: 2 days ago
Medically reviewed by Dr. Baraa Alnahhal, MD · Last reviewed: October 2026
Quick Answer: Key Facts About Migraine with Aura
Migraine with aura is a recurring headache paired with nervous system symptoms, most often vision changes, that usually last less than an hour. It stems from a wave of brain activity that does not harm the brain. Treatment includes relief medicines taken at the first aura sign. New temporary vision loss, speech difficulty or one-sided weakness need urgent care. [1] [2]
Question | Answer |
What is it? | A recurring headache paired with nervous system symptoms (aura) — most often vision changes — that usually last less than an hour. |
How common is it? | Migraine affects about 12–15% of people; about 25% of people with migraine experience aura. [4] |
What causes it? | A wave of electrical or chemical activity spreading across the brain (cortical spreading depression) — it does not harm the brain. |
How is it treated? | Relief medicines taken at the first aura sign, daily preventive medicines for frequent attacks, and self-care habits like a regular sleep and meal schedule. |
When to act fast? | New temporary vision loss, speech or language difficulty, or muscle weakness on one side of the body need immediate medical attention. |
What the research says
Migraine with aura is linked to about twice the risk of ischemic stroke. In a BMJ systematic review and meta-analysis of case-control and cohort studies, people with migraine with aura had a pooled relative risk of 2.16 (95% CI 1.53–3.03) for ischemic stroke, compared with 1.23 (0.90–1.69) for migraine without aura. The risk was higher in women (2.08) than in men (1.37), and age under 45, smoking, and oral contraceptive use increased it further. (Schürks et al., BMJ, 2009) [5]
A more recent meta-analysis found the same pattern. Pooling studies published up to December 2021, migraine with aura was associated with a 2.17-fold risk of ischemic stroke (95% CI 1.78–2.64) and a 1.95-fold risk of total stroke (1.62–2.34), versus 1.34 (1.11–1.62) for ischemic stroke in migraine without aura. Results varied a lot between studies (I² 89.2% for ischemic stroke). (Zhang et al., Neurol Sci, 2022) [6]
A newer class of oral medicines, the gepants, beats placebo for stopping an attack. In a randomized trial of 1,672 adults with migraine with or without aura, 21.2% taking ubrogepant 100 mg and 19.2% taking 50 mg were pain-free at 2 hours, versus 11.8% on placebo. Freedom from the most bothersome symptom at 2 hours was 37.7% and 38.6% versus 27.8%. The most common side effects were nausea, sleepiness, and dry mouth. (Dodick et al., N Engl J Med, 2019) [7]
What is a migraine with aura?
Migraine with aura, once called classic migraine, is a recurring headache that strikes after or at the same time as nervous system symptoms called aura. Aura symptoms usually last less than an hour. [1]
The word aura simply means warning signs from the nervous system. These can include flashes of light, blind spots, and other vision changes that affect both eyes. Aura can also cause tingling in the hand or face. Sometimes people who have migraine with aura also experience muscle weakness or issues with speech and language. Visual aura symptoms are the most common. [1]
Migraine with aura and migraine without aura (once called common migraine) are usually treated the same way. Treatment includes medicines to prevent migraine with aura and medicines to stop the headache once it has started. Relaxation techniques such as massage can help too. Self-care steps — following a regular sleep and meal schedule and avoiding personal triggers — can help prevent attacks. [1]
What does a migraine aura feel like?
Migraine aura symptoms are temporary visual or other disturbances. Aura symptoms usually strike before other migraine symptoms such as intense head pain, nausea, and sensitivity to light and sound. [1]
The timing usually follows a familiar pattern. Migraine aura usually occurs within an hour of when headache pain begins, and it generally lasts less than 60 minutes. But aura can happen at the same time as the headache. Rarely, aura can happen without a headache following it — when this happens, it is usually in people over age 50. [1]
Timing feature | What typically happens |
When aura appears | Usually before other migraine symptoms; often within an hour of the head pain starting [1] |
How long aura lasts | Generally less than 60 minutes [1] |
Aura at the same time as pain | Can happen [1] |
Aura without a headache | Rare; usually in people over age 50 [1] |
What vision changes are most common?
Most people who have migraine with aura develop temporary visual symptoms. These tend to start in the center of the field of vision and spread outward. [1]
Visual aura symptom | How it looks |
Blind spots (scotomas) | Patches of missing vision, sometimes outlined by simple shapes such as a circle [1] |
Zigzag lines | Lines that gradually float across your field of vision [1] |
Shimmering spots or stars | Glittering specks that drift through your sight [1] |
Changes in vision or vision loss | Blurry or missing areas of vision [1] |
Flashes of light | Brief bright lights in your field of vision [1] |
What other symptoms can an aura cause?
Beyond vision changes, temporary disturbances sometimes associated with migraine aura include the following.
Other aura disturbance | Description |
Tingling or numbness | In one hand or on one side of the face; may spread slowly along an arm or leg and may turn into numbness [1] |
Mouth or tongue tingling | Numbness or tingling of the tongue or mouth [1] |
Speech or language trouble | Difficulty speaking or finding words [1] |
Ear noises | Ringing in the ears or other noises [1] |
Hearing loss | Temporary [1] |
Weakness or paralysis | Inability to move part of the body, or muscle weakness [1] |
What causes migraine with aura?
Migraine with aura is thought to be caused by electrical or chemical waves that move across the brain, called cortical spreading depression. Scientists call this wave cortical spreading depression. The part of the brain where the wave spreads determines the symptoms you might experience. [1] [4]
Electrical or chemical waves can occur in areas that process sensory signals, in speech centers, or in centers that control movement. The most common type of aura is visual aura. It occurs when a wave of electrical activity spreads through the visual cortex — the part of the brain that handles sight — and causes visual symptoms. This wave is also thought to cause the headache pain that typically follows aura. [1]
An important point of reassurance: electrical and chemical waves can occur with typical functioning of the nerves and do not cause harm to the brain. [1]
What triggers a migraine with aura?
Migraine and migraine with aura share many of the same triggers. [1]
Trigger | Examples |
Stress | Stress [1] |
Sensory overload | Bright lights and loud sounds [1] |
Smells | Being around smoke or strong odors [1] |
Alcohol | Drinking too much alcohol, especially wine [1] |
Caffeine | Consuming too much caffeine [1] |
Foods | Some foods, including processed foods or those with additives such as MSG [1] |
Sleep changes | Too much or too little sleep [1] |
Hormones | Menstruation and other hormonal changes [1] |
Who is most likely to get migraine with aura?
Although no specific factors appear to increase the risk of migraine with aura itself, migraines in general seem to be more common in people with a family history of migraine. [1]
Migraines also are more common in people assigned female at birth. This may be related to hormonal changes in people assigned female at birth. [1]
What complications should you know about?
People who have migraine with aura are at a mildly increased risk of stroke. Depression, anxiety, and sleep issues also are more common in people with migraine, including migraine with aura. [1]
Taking too many medicines to treat migraines can lead to another type of headache called medication overuse headache (MOH). [1] [3] This is why doctors advise using relief medicines carefully and not too often.
Can migraine with aura be confused with other conditions?
Migraine with aura sometimes can be confused with a rare type of migraine called retinal migraine. Retinal migraines can cause similar symptoms such as vision changes, but these symptoms occur in one eye only. Vision changes and vision loss are temporary with retinal migraine, and many people do not have a headache. [1]
There are other potential causes of vision loss in one eye that should be examined by a healthcare professional, so it is important not to assume this symptom means you have a retinal migraine. [1]
How is migraine with aura diagnosed?
Your healthcare professional might diagnose migraine with aura based on your symptoms, your medical and family history, and a physical exam. There is no specific test to diagnose migraine with aura. [2]
To make the diagnosis, your healthcare professional will look for a history of repeated headaches that include the following features.
Sign looked for | Description |
One-sided pain | Pain on one side of the head [2] |
Pulsing pain | Pain that pulses and throbs [2] |
Vision changes | Temporary visual disturbances or vision loss [2] |
Hearing changes | Temporary hearing loss [2] |
Nausea | Feeling sick to your stomach [2] |
Sensitivity | Sensitivity to light and sound [2] |
If your aura is not followed by head pain, your healthcare professional might recommend certain tests to rule out more-serious conditions, such as a transient ischemic attack (TIA) — a temporary interruption of blood flow to the brain sometimes called a "mini-stroke." [2]
Assessment | What it does | When it is used |
Eye examination | An eye specialist (ophthalmologist) checks for eye problems that might cause visual symptoms [2] | To rule out eye causes [2] |
Head CT scan | An X-ray technique that produces detailed images of the brain [2] | Not usually needed; used if symptoms are not typical or there is an unusual exam finding [2] |
Brain MRI | An imaging procedure that produces detailed images of the brain [2] | Not usually needed; used if symptoms are not typical or there is an unusual exam finding [2] |
Neurologist referral | A doctor who specializes in nervous system conditions rules out brain conditions [2] | To rule out other brain conditions [2] |
How is migraine with aura treated?
For migraine with aura, just as with migraine alone, treatment is aimed at relieving migraine pain. [2]
What medicines stop an attack?
Medicines used to relieve migraine pain work best when taken at the first sign of an oncoming migraine — as soon as signs and symptoms of a migraine aura begin. [2] [3] Depending on how severe your migraine pain is, medicines that can be used to treat it include the following.
Medicine type | How it works | Key points |
Pain relievers | OTC aspirin and ibuprofen (Advil, Motrin IB); other medicines may be prescribed [2] | Taken too frequently, these might cause medication overuse headaches and possibly ulcers and bleeding in the digestive tract [2] |
Combination pain medicine | Caffeine, aspirin, and acetaminophen together (Excedrin Migraine) [2] | May help, but usually only against mild migraine pain [2] |
Triptans | Prescription drugs such as sumatriptan (Imitrex, Tosymra) and rizatriptan (Maxalt, Maxalt-MLT) that block pain pathways in the brain [2] | Taken as pills, shots, or nasal sprays; relieve many symptoms; might not be safe for those at risk of a stroke or heart attack [2] |
Dihydroergotamine | Nasal spray or injection (D.H.E. 45, Migranal) [2] | Most effective shortly after symptoms start for migraines that last longer than 24 hours; can worsen migraine-related vomiting and nausea; avoid with coronary artery disease, high blood pressure, or kidney or liver disease [2] |
Lasmiditan | Newer oral tablet (Reyvow) approved for migraine with or without aura [2] | Significantly improved headache pain in drug trials; can cause sedation and dizziness — do not drive or operate machinery for at least eight hours after taking it [2] |
CGRP antagonists | Oral tablets ubrogepant (Ubrelvy) and rimegepant (Nurtec ODT); nasal spray zavegepant (Zavzpret) [2] | More effective than placebo at relieving pain, nausea, and light and sound sensitivity two hours after taking; side effects include dry mouth, nausea, and excessive sleepiness; ubrogepant and rimegepant should not be taken with strong CYP3A4 inhibitor drugs [2] |
Anti-nausea drugs | Chlorpromazine, metoclopramide (Reglan), or prochlorperazine (Compro) [2] | Help when migraine is accompanied by nausea and vomiting; usually taken with pain medicines [2] |
Opioid medications | Strong pain medicines | Highly addictive and can cause medication overuse headaches; usually should be avoided [2] |
Some of these medicines are not safe to take during pregnancy. If you are pregnant or trying to get pregnant, do not use any of these medicines without first talking with your healthcare professional. [2]
What medicines prevent attacks?
Medicines taken regularly can help prevent frequent migraines, with or without aura. Your healthcare professional might recommend preventive medicines if you have frequent, long-lasting, or severe headaches that do not respond well to treatment. [2]
Preventive medicine is aimed at reducing how often you get a migraine headache, how severe the attacks are, and how long they last. [2]
Preventive medicine | Examples | Key points |
Blood pressure-lowering medicines | Beta blockers: propranolol (Inderal, InnoPran XL), metoprolol (Lopressor); calcium channel blocker: verapamil (Verelan) [2] | Verapamil may help prevent migraines with aura if other medicines have not been effective [2] |
Antidepressants | Amitriptyline (a tricyclic antidepressant) [2] | Can prevent migraines; because of side effects such as sleepiness, other antidepressants might be prescribed instead [2] |
Anti-seizure drugs | Valproate and topiramate (Topamax, Qudexy XR) [2] | Can help with less frequent migraines; side effects include dizziness, weight changes, and nausea; not recommended for people who are pregnant or trying to get pregnant [2] |
Botox injections | OnabotulinumtoxinA (Botox) about every 12 weeks [2] | Helps prevent migraines for some adults [2] |
CGRP monoclonal antibodies | Erenumab-aooe (Aimovig), fremanezumab-vfrm (Ajovy), galcanezumab-gnlm (Emgality), eptinezumab-jjmr (Vyepti) [2] | FDA-approved; given monthly or quarterly by injection; most common side effect is a reaction at the injection site [2] |
CGRP antagonists (gepants) | Atogepant (Qulipta), rimegepant (Nurtec) [2] | Approved for migraine prevention [2] |
Ask your healthcare professional if these medicines are right for you. Some are not safe to take during pregnancy. If you are pregnant or trying to get pregnant, do not use any of these medicines without first talking with your healthcare professional. [2]
What can you do at home?
When symptoms of migraine with aura start, try heading to a quiet, darkened room. Close your eyes and rest or take a nap. Place a cool cloth or an ice pack wrapped in a cloth on your forehead. [2]
Other practices that might soothe migraine with aura pain include the following.
Self-care practice | What to do |
Relaxation techniques | Biofeedback and other forms of relaxation training teach ways to deal with stressful situations, which might reduce the number of migraines [2] |
Sleep and eating routine | Do not sleep too much or too little; set and follow a consistent daily sleep and wake schedule; eat meals at the same time every day [2] |
Hydration | Drink plenty of fluids; staying hydrated, particularly with water, might help [2] |
Headache diary | Log when headaches happen and what your day was like, including schedule, meals, and mood — this helps you spot and avoid personal triggers [2] |
Common migraine triggers include loud noises, certain odors, foods, and alcohol. If you learn what triggers migraines with aura for you, you can take steps to avoid those things. [2]
When should you see a doctor?
If you regularly experience signs and symptoms of migraine with aura, keep a record of your migraine attacks and what you did to treat them. Make an appointment with your healthcare professional to discuss your headaches. [1]
Even if you have a history of headaches, see your healthcare professional if the pattern changes or your headaches suddenly feel different. [1]
See your healthcare professional immediately if you have new signs and symptoms of migraine with aura, such as temporary vision loss, speech or language difficulty, and muscle weakness on one side of your body. Your healthcare professional will need to rule out more serious conditions, such as a stroke. [1]
How should you prepare for your appointment?
If you are having temporary visual or sensory disturbances, see your primary healthcare professional. In some cases, you may be referred to a neurologist — a doctor who specializes in the nervous system. [2]
Here is information to help you get ready for your appointment.
What questions should you ask?
Some basic questions to ask your healthcare professional include the following.
Question | Why it helps |
What is the likely cause of my symptoms? | Points to the right diagnosis |
What tests, if any, do I need? | Helps you prepare for what comes next |
Is my condition likely temporary or chronic? | Sets expectations for the future |
What treatments are available, and which do you recommend? | Clarifies your options |
How can I best manage other health conditions together with this one? | Coordinates your care |
Are there dietary restrictions I need to follow? | Turns diet changes into a clear plan |
What will your doctor ask?
Your healthcare professional is likely to ask a number of questions, including: [2]
When did you begin having symptoms?
What types of visual symptoms or other sensations do you have?
How long do they last?
Are they followed by a headache?
If you have headaches, how often do you get them and how long do they last?
How severe are your symptoms?
What, if anything, seems to improve your symptoms?
What, if anything, appears to worsen your symptoms?
What can you do in the meantime?
Keep a headache diary. Write a description of each incident of visual disturbances or unusual sensations. Include when they occurred, how long they lasted, and what triggered them. A headache diary can help your healthcare professional diagnose your condition and track your progress between visits. [2]
Also write down key personal information, including major stresses or recent life changes, and write down the questions you want to ask. [2]
Conclusion and next steps
Migraine with aura is a recurring headache that arrives with nervous system warning signs — most often flashes of light, blind spots, or other vision changes that typically last less than an hour. The cause is a wave of electrical or chemical activity moving across the brain, and this wave does not harm the brain. Because there is no specific test, diagnosis rests on your symptom history, and unusual symptoms may prompt imaging to rule out more serious conditions. Most people manage well with a combination of relief medicines taken early, preventive medicines when attacks are frequent, and everyday habits such as steady sleep, hydration, and a headache diary that exposes personal triggers. If your symptoms are new or change pattern, contact your healthcare professional promptly. [1] [2]
Talk with a healthcare professional. If you regularly experience aura symptoms or your headaches change pattern, see a healthcare professional for diagnosis and treatment. If you develop new temporary vision loss, speech difficulty, or one-sided weakness, seek emergency care right away. For more plain-language guides on headaches, nerves, and chronic conditions, explore the related articles on Rinnit.com.
Frequently Asked Questions
What is a migraine with aura?
A migraine with aura is a recurring headache that strikes after or at the same time as nervous system symptoms called aura — most often vision changes such as flashes of light or blind spots. Aura usually lasts less than an hour. [1]
What does a migraine aura look like?
Most people develop temporary visual symptoms that start in the center of the field of vision and spread outward. These include blind spots, zigzag lines, shimmering spots or stars, changes in vision or vision loss, and flashes of light. [1]
How long does a migraine aura last?
A migraine aura usually strikes before the headache, occurs within an hour of when head pain begins, and generally lasts less than 60 minutes. Rarely, aura happens without a following headache, usually in people over age 50. [1]
What causes migraine with aura?
Evidence points to electrical or chemical waves moving across the brain, called cortical spreading depression. When the wave spreads through the visual cortex, it causes visual symptoms and is also thought to cause the headache that follows. These waves occur with normal nerve function and do not harm the brain. [1]
Is migraine with aura dangerous?
People with migraine with aura are at a mildly increased risk of stroke, and depression, anxiety, and sleep issues are more common in people with migraine. New temporary vision loss, speech trouble, or one-sided weakness needs immediate evaluation to rule out a stroke. [1]
How is migraine with aura treated?
Relief medicines — pain relievers, triptans, CGRP antagonists, and others — work best at the first aura sign. Daily preventive medicines (blood pressure medicines, antidepressants, anti-seizure drugs, Botox, or CGRP injections) help when attacks are frequent or severe. Self-care such as a regular sleep schedule, hydration, and trigger tracking also helps. [2]
Can medicines make migraines worse?
Yes. Taking pain medicines too frequently can cause medication overuse headaches (MOH), and opioids are highly addictive and usually should be avoided. [2]
What self-care steps help?
Rest in a quiet, darkened room with a cool cloth or wrapped ice pack on the forehead. Keep a consistent sleep and meal schedule, drink plenty of water, and keep a headache diary to identify and avoid personal triggers such as bright lights, stress, alcohol, and certain foods. [1] [2]
Related Reading
Read next on Rinnit.com:
References
Mayo Clinic Staff. Migraine with aura - Symptoms & causes. Mayo Clinic. September 11, 2025. https://www.mayoclinic.org/diseases-conditions/migraine-with-aura/symptoms-causes/syc-20352072
Mayo Clinic Staff. Migraine with aura - Diagnosis & treatment. Mayo Clinic. September 11, 2025. https://www.mayoclinic.org/diseases-conditions/migraine-with-aura/diagnosis-treatment/drc-20352077
World Health Organization. Migraine and other headache disorders. WHO. October 24, 2025. https://www.who.int/news-room/fact-sheets/detail/headache-disorders
Kikkeri NS, et al. Migraine With Aura. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2024. PMID 32119498. https://www.ncbi.nlm.nih.gov/books/NBK554611/
Schürks M, et al. Migraine and cardiovascular disease: systematic review and meta-analysis. BMJ. 2009;339:b3914. PMID 19861375. https://doi.org/10.1136/bmj.b3914
Zhang S, et al. Association between migraine and risk of stroke: a systematic review and meta-analysis. Neurol Sci. 2022;43(8):4875-4889. PMID 35451664. https://doi.org/10.1007/s10072-022-06074-z
Dodick DW, et al. Ubrogepant for the Treatment of Migraine. N Engl J Med. 2019;381(23):2230-2241. PMID 31800988. https://doi.org/10.1056/NEJMoa1813049
Medical disclaimer
This article is for informational purposes only and is not medical advice. Always consult a qualified healthcare professional for diagnosis and treatment decisions.
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