Aura

What is the Aura Phase of a Migraine?  

The second phase of migraine is called the aura phase. During this phase, an individual may experience visual disturbances such as blurry vision and temporary loss of sight. One may see flashes of light or geometric shapes appear. There are also somatosensory types of aura such as numbness or tingling throughout the body, or auditory disturbances. The aura phase may last between a few minutes and up to an hour [4]. 

Various tests and research data have shown that migraine attacks with aura increase with age and are more common among elderly patients [5]. Patients who experience migraine-with-aura are also at higher risk for developing a stroke. Since migraine is more common in women than men, more women than men experience aura effects [6].

The aura phase of migraine is not dangerous, but it can feel scary when experiencing loss of sight, blurry vision, or other disturbances. Getting an accurate diagnosis from a doctor is essential to identify the cause and get proper treatment [7]. 

Importantly, only about 1 in 4 people living with migraine will experience aura [4].

What are the Types of Migraine with Aura? 

There are four types of migraine with aura: a migraine with or without head pain, brainstem aura migraine, hemiplegic migraine, and retinal migraine. Of the four types of migraine with aura, the most common type is a regular migraine with or without head pain [8].  

Individuals experiencing a brainstem aura migraine may experience vertigo, ataxia, pain in the back of the head, ringing in the ears, double vision, impaired hearing, or difficulty speaking. Brainstem aura is uncommon. Patients experiencing brainstem aura symptoms need to be carefully checked by their doctor with an EEG to rule out seizures [9]. 

Hemiplegic migraine is a rare type of migraine. Its symptoms include weakness on one side of the body, along with other aura signs like blurry vision, visual distortions, or nausea. This type of aura migraine can either run in the family or be present with no family history. Symptoms can mimic a stroke, seizure, or other complex neurological conditions. It is vital to seek medical help if you experience these symptoms [10]. 

Retinal migraine is another rare form of migraine in which an individual may experience aura effects in only one eye. Flashes of light, zig-zags, or geometric shapes may appear in one’s vision. Temporary loss of vision and blind spots are other symptoms. This type differs from a regular aura migraine in which visual distortions occur in both eyes rather than just one [8]. 

What is the Difference Between Prodrome and Aura Migraine Phases?  

The first phase of migraine is the prodrome stage which can last from several hours to a few days [2]. Prodromal symptoms may include neck stiffness, fatigue, sensitivity to light, sensitivity to sound, irritability, mood changes. After that, some people, but not everyone, will experience the aura phase.  

Aura can appear without prodromal symptoms preceding it. Aura differs from the prodrome phase in that aura is sensory-related [11]. Neurology patients in the aura phase may experience changes in vision, temporary loss of sight, sensitivity to light or noise, or somatosensory symptoms like numbness and tingling. This aura may last between a few minutes to an hour. There may also be some overlap in which symptoms of aura begin while an individual is also still experiencing symptoms of the prodrome phase. 

Both phases have non-headache symptoms and come before the headache attack and postdrome stages. If treated during these earlier stages, individuals may reduce the severity of the painful headache attack or even avoid it. 

 Aura Phase Symptoms: Quick Reference  

The aura migraine phase may include these non-headache symptoms: 

• Blurry vision
• Temporary loss of sight 
• Visual disturbances like flashes of light or geometric shapes 
• Numbness or tingling in the body 
• Increased sensitivity to sensory stimulation 
• Auditory sensations 
  

Nerivio’s Quick Q&A Guide on Navigating A Migraine

“Can I treat migraine in the aura phase?”

If you are experiencing aura, know that help is available. Treating during the aura phase can help many individuals ease or eliminate the later stages of their migraine attacks. 

Talk with a healthcare provider to get an accurate diagnosis of the neurological disease and about the most effective and safe treatments available. Nerivio is a drug-free therapy for acute and preventive treatment of migraine with or without aura. Ask your doctor if Nerivio is right for you.

“How can I prevent migraine with auras?”

• Although no cure currently exists for this complex brain disease, there are tools and treatments available to help manage migraine symptoms. For example, during a clinical trial, when participants used Nerivio every other day for 45 minute preventive treatments, it provided an average reduction of 4 migraine days per month. Moreover, over half of patients reduced their days of moderate to severe headaches by 50% in a month [17]. Patients desiring to prevent aura or other migraine phase symptoms can begin by talking with their doctor about available treatments. 
• Many individuals also find that relaxing in a dark room away from bright or flickering lights and from noise can help soothe symptoms.  
• Avoid any foods that typically set off a migraine. A few common food triggers are caffeine, chocolate, and wine [12]. 
• Other triggers may be hormonal fluctuations, menstrual cycle, or environmental factors including weather [13]. Engaging in physical activities may also help the symptoms pass. Be sure to update a doctor when discovering specific triggers and patterns in your symptoms [14].

“What migraine treatment options are available?”

Your healthcare provider may recommend over-the-counter pain medications like ibuprofen, naproxen sodium, acetaminophen. Your provider may prescribe abortive treatments for migraine like triptans (e.g., sumatriptan,  rizatriptan), gepants (e.g., nurtec, ubrelvy) or other. Patients who have frequent migraine attacks may also benefit from preventive migraine treatments. 

There are a few FDA-approved medicines for the acute treatment of migraine which are considered safe to use. Many of them, however, may have drug-to-drug interactions or side effects like insomnia, drowsiness, nausea, or hallucination [15][16]. 

For a safer, drug-free alternative, ask your healthcare provider about Nueromodulation to manage your migraine. Nerivio is a Remote Electrical Neuromodulation (REN) therapy, indicated for acute and preventive treatment of migraine, in patients age 12 and up. It is a prescription use, self-administered device used every other day for migraine prevention and/or at the onset of migraine or aura to treat migraine attack. 

Visit our step-by-step guide for more information about getting the Nerivio drug-free migraine treatment.

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Sources:

1. National Health Service (NHS). (n.d.). Treatment. https://www.nhs.uk/conditions/migraine/treatment/
2. Cleveland Clinic. (n.d.). Migraine headaches. https://my.clevelandclinic.org/health/diseases/5005-migraine-he target=”_blankadaches 
3. Mayo Clinic. (2021, July 02). Migraine. https://www.mayoclinic.org/diseases-conditions/migraine-headache/diagnosis-treatment/drc-20360207 
4. Kikkeri, N.S., & Nagalli, S. (2020). Migraine with Aura. StatPearls. https://www.ncbi.nlm.nih.gov/books/NBK554611/?report=classic 
5. Vongvaivanich, K., Lertakyamanee, P., Silberstein, S. D., & Dodick, D. W. (2015). Late-life migraine accompaniments: A narrative review. Cephalalgia, 35(10), 894-911. https://journals.sagepub.com/doi/pdf/10.1177/0333102414560635 
6. Allais, G., Chiarle, G., Sinigaglia, S., Airola, G., Schiapparelli, P., & Benedetto, C. (2020, August 26). Gender-related differences in migraine. Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7704513/
7. American Migraine Foundation. (2023, March 01). Understanding Migraine with Aura. https://americanmigrainefoundation.org/resource-library/understanding-migraine-aura/ 
8. American Migraine Foundation. (2023, January 19). What Type Of Headache Do You Have? https://americanmigrainefoundation.org/resource-library/what-type-of-headache-do-you-have/ 
9. American Migraine Foundation. (2016, October 8). Migraine with Brainstem Aura (Basilar Type Migraine) https://americanmigrainefoundation.org/resource-library/migraine-with-brainstem-aura/ 
10. National Organization for Rare Disorders (NORD). (2019). Hemiplegic Migraine. https://rarediseases.org/rare-diseases/hemiplegic-migraine/ 
11. American Migraine Foundation. (2022, March 17). Migraine Prodrome: Symptoms and Prevention. https://americanmigrainefoundation.org/resource-library/migraine-prodrome-symptoms-prevention/ 
12. American Migraine Foundation. (2017, July 27). Top 10 Migraine Triggers And How to Deal With Them. https://americanmigrainefoundation.org/resource-library/top-10-migraine-triggers/ 
13. National Health Service (NHS). (n.d.). Causes. https://www.nhs.uk/conditions/migraine/causes/ 
14. National Library of Medicine J Headache Pain. 2018; 19(1): 83. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6134860/
15. Lew, C., & Punnapuzha, S. (2022). Migraine medications. In StatPearls. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK553159/
16. U.S. Food & Drug. (2017, February 23) Treating Migraines: More Ways to Fight the Pain https://www.fda.gov/consumers/consumer-updates/treating-migraines-more-ways-fight-pain 
17. Tepper SJ, et al. Remote electrical neuromodulation for migraine prevention: A double-blind, randomized, placebo-controlled clinical trial. Headache. 2023. doi: 10.1111/head.14469. https://headachejournal.onlinelibrary.wiley.com/doi/10.1111/head.14469 

Safety Information

DISCLAIMER
It is highly recommended that you consult your doctor before taking any action based on the information above. This content does not constitute medical advice or a recommendation.

INDICATION FOR USE
Nerivio is an FDA-cleared, drug-free therapy for acute and preventive treatment of migraine with or without aura in patients 12 years and up. It is a prescription use, a self-administered device for use in the home environment at the onset of migraine headache or aura for acute treatment, or every other day for preventive treatment.

CONTRAINDICATIONS
Nerivio should not be used by people with uncontrolled epilepsy, an active implantable medical device, such as a pacemaker, hearing aid implant, or any implanted electronic device. Such use could cause electric shock, electrical interference or serious injuries or medical conditions.”

IMPORTANT SAFETY INFORMATION
For full user instructions and safety information, please see the Nerivio User Manual.
Talk to your doctor to see if Nerivio is right for you.