What are Migraines with Aura

Migraine with aura is a type of headache that affects 5% of the general population. Women tend to get migraines more often than men.  Migraine headaches are severe, with the pain occurring behind the eye or in the back of the head. Many describe the headache starting on the same side of the head each time, though from my experience every once in a while my migraine will appear on the opposite side.

Headache researchers Dr. Queiroz and colleagues (2002) studied visual auras of 100 patients with migraine with aura. They found that migraine patients had visual aura 40% of the time. While only 20% of the headache sufferers had visual aura with every attack, these optical disturbances lasted between 1 and 30 minutes when they did occur. The most common phenomenon was described as ‘small bright dots’. Other patients described ‘flashes of light’, ‘blind spots’, and ‘foggy vision’. More than half of the patients had a combination of these phenomena.

What Causes Migraine with Aura?

Migraine with aura is a complex disorder that occurs during adolescence or young adulthood. Most migraine sufferers start noticing symptoms between the ages of 10 and 45 years. Migraines are caused by abnormal brain activity, triggered by a variety of factors. Headache experts believe the attack starts in the brain, involving chemicals and nerve pathways.   Alterations to these pathways – along with chemical imbalances – affect normal blood flow in the brain and surrounding tissues.  However scientists still are not sure why some will get the aura part of a migraine.

Many things can trigger a migraine with aura, including stress, anxiety, alcohol, odors, loud noises, bright lights, and cigarette smoke.

What are Some Common Migraine Triggers?

Certain things ‘trigger’ the onset of a migraine with aura. If you suffer from these headaches, learn which trigger affects you and avoid the activity or substance.

  • Lack of sleep or too much sleep
  • Missed Meals
  • Caffeine Withdrawal
  • Changes in Hormone Levels otherwise known as menstrual migraines
  • Exercise or Physical Stress especially if this causes dehydration
  • Foods that Contain Monosodium Glutamate (MSG)
  • Smoking or Smoke Exposure
  • Listening to Loud Music
  • Bright Lights
  • Perfumes, Chemical Cleaning Agents, and Strong Odors
  • Alcohol and Smoke

 

What Foods Should I Avoid?

Certain foods and beverages cause migraine with aura. If you have this type of headache after eating certain things, avoid that food or beverage in the future.  Examples of foods that might trigger your migraine are:

  • Processed, Pickled, Fermented, or Marinated items
  • Foods that Contain Monosodium Glutamate (MSG)
  • Certain Fruits:  Bananas, Avocados, and Citrus
  • Meats with Nitrates:  Hot Dogs, Bacon, and Salami
  • Foods with Tyramine:  Aged Chees, Red Wine, Chicken Livers, and Smoked Fish

Are Migraines Inherited?

Medical researchers believe that heredity is a factor for a patient’s predisposition to getting migraine with aura. They estimate that approximately 60% of migraine sufferers have one or more close relatives with the same disorder. However, within families with two or more migraine sufferers, the triggers vary from family member to family member. With my family I had one person on each side that suffered from migraines and yes all of us had different triggers and we were each impacted differently when we did have migraines.

What are the Symptoms of Migraines with Aura?

Migraine with aura is characterized by fleeting significant neurological symptoms called ‘aura’. This headache condition involves more than just pain. Aura can be visual or sensory or both. Descriptions of aura by migraine sufferers include ‘zigzag lines’, ‘flickering light’, and blind spots.

The symptoms of aura gradually develop and often spread over the area of significance, such as the visual field or across the face or head. Following the aura symptoms, patients have headache, nausea, vomiting, sensitivity to noise, and/or intolerance to light. Other symptoms of migraine with aura include:

  • A temporary blind spot
  • Blurred vision
  • Eye pain
  • Seeing stars or zigzag lines
  • Tunnel vision
  • Yawning
  • Trouble finding the right words
  • Difficulty concentrating
  • Numbness, tingling, or weakness
  • Loss of appetite

These symptoms of migraines with aura might occur right before and during the migraine but some have reported these being warning signs a day or two in advance.

How are Migraines with Aura Diagnosed?

According to the International Headache Society (IHS), migraines with aura are classified on the basis of a clinical interview with your doctor as well as a physical examination. If you think you have migraines, see your doctor for an evaluation. He or she can diagnose migraine with aura based on a series of questions related to your symptoms and family history.

Expect the doctor to do a complete physical examination to rule out other headache types and causes. While there is no specific blood test or diagnostic imaging exam to prove you have migraines, your doctor may order a CT (cat scan) of the head or brain MRI (magnetic resonance imaging) to rule out serious conditions.

How are Migraines with Aura Treated?

There is no cure for migraine headaches, with or without aura. Doctors treat the symptoms of migraine with aura and try to prevent these symptoms from occurring or worsening. Treatment involves three main things:  identification, symptom relief, and prevention.

Identification and the Headache Diary – The main thing you can do is to identify your headache triggers by keeping a ‘headache diary’. Just jot down what you were doing before your headache started. Include foods you recently ate, as well as alcohol and cigarette usage. Many people find that they can pinpoint the exact cause of their migraines.   While this can take a while it is worth the effort.  Over the years I have been able to decrease my migraines in half due to identifying my triggers.

Symptoms Relief and Common Medications – There are many medications doctors prescribe to reduce the number of attacks. These are called ‘preventive’ medicines. These include beta blockers, calcium channel blockers, antidepressants, and seizure drugs. If the preventive medicines don’t help, your doctor may prescribe an ‘abortive’ agent. These include the triptans or the ergots (derived from ergotamine).

Prevention through Avoidance – Many migraine sufferers find that they can prevent their migraine by the avoidance of triggers. Discuss your trigger with your doctor to find alternatives and inventive ways to evade migraine with aura.

References

Pub Med Health (2013). Migraine. Retrieved on February 20, 2013 from:

http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001728/

Queiroz, L.P. et al. (2002). Characteristics of migraine visual aura. Cephalagia, 37(3):  137 – 141. DOI: 10.1046/j.1526-4610.1997.3703137.x

Rasmussen, B.K. & Olesen, J. (2002). Migraine with aura and migraine without aura: an epidemiological study. Cephalalgia, 12(4):  221 – 228. DOI: 10.1046/j.1468-2982.1992.1204221.x

Russell, M.B. & Olesen, J. (2002). The genetics of migraine without aura and migraine with aura. Cephalalgia, 13(4):  245 – 248. DOI: 10.1046/j.1468-2982.1993.1304245.x