What is a Migraine With Aura?

Written by Kathleen Morrison
Medically Reviewed by Andrea Sleeth WHNP-BC, MSCP

Key takeaways

• Migraines with aura give your body an early heads-up with visual, sensory, or speech changes that usually appear 10 to 60 minutes before the headache starts.
• Visual auras are the most common, but tingling, numbness, difficulty speaking, and balance issues can also signal an oncoming migraine.
• Auras happen because of shifts in brain electrical activity, changes in nerve function, genetics, and triggers like hormones, stress, sleep, and certain foods.
• Knowing your personal triggers and having a plan—whether that’s medications, calming techniques, or hormone-friendly birth control—can help give you a sense of control over your migraines.

Ever seen flashing lights or zigzag patterns before a migraine hits? You’re not imagining it. That’s called a migraine with aura, and it’s actually pretty common. A number of people who get migraines experience these early warning signs before the pain even starts.

A migraine with aura can bring more than just a pounding headache. You might notice vision changes, tingling sensations, or even find it tricky to get your words out. These symptoms usually show up anywhere from 10 to 60 minutes before the migraine itself, giving you a short but valuable window to take action and care for yourself.

So, what’s actually happening here? During the aura phase, your brain’s electrical activity shifts, creating those strange visual effects or sensations. It can be unsettling, but it’s also a helpful signal from your body. When you know what to look for—and what tends to set your migraines off—you’re in a much stronger position to manage them.

Early signs of a migraine with aura

Sometimes, migraine headaches don’t just show up, they send little warning signs first. These early cues, called aura symptoms, often build gradually over 5 to 20 minutes and can last up to an hour. The key is learning to recognize them so you can take action early, whether that means grabbing your meds, finding a quiet spot, or simply giving yourself permission to pause.

Visual auras

Visual migraine auras are the most common. They happen to almost 9 out of 10 people who get migraine with aura. You might notice things like:

• Shimmering zigzags that look like cracks in glass or lightning bolts
• Flashes or sparkles of light that flicker or drift across your vision
• Blind spots or blurry patches that make it hard to read or focus
• Kaleidoscope-like patterns or tunnel vision, where everything looks distorted or colorful

Visual symptoms usually start small and spread outward, and while they can be unsettling, they’re temporary. They happen because of short-term changes in the brain’s visual processing, not because anything is permanently “wrong.”

Speech and other sensory issues

Sometimes, your senses or speech get caught up, too. Here’s what that can look like:

• Tingling or numbness that starts in your fingertips and moves up your arm or face
• Pins-and-needles sensations that make your skin feel buzzy or “asleep”
• Difficulty speaking clearly, even when you know what you want to say
• Trouble reading or understanding words for a few minutes
• In rare cases, temporary weakness on one side (called hemiplegic migraine) or dizziness and balance issues (brainstem aura)

These sensations can feel strange or even scary, but they’re short-lived and a signal from your body that it’s time to slow down.

If any of these symptoms ever happen for the first time, or feel more intense than usual, it’s a good idea to check in with a healthcare provider just to be safe.

What causes a migraine aura?

Migraine auras happen because your brain decides to throw a little electrical party—not the fun kind. Here’s some science for you (we’ll keep it simple):

• Cortical spreading depression: This slow-moving wave of electrical activity sweeps across your brain at about 3 millimeters per minute. As it passes through different areas, it temporarily disrupts normal function and creates the classic aura symptoms.
• Nervous system changes: Your nerve cells get overexcited and then suddenly stop working properly, which messes with blood flow and triggers the visual, sensory, and other neurological symptoms you feel.
• Inflammatory response: The same processes that cause the aura also prompt the release of substances that lead to headache pain later on.
• Genetics: Migraine aura often runs in families. If a parent or sibling gets these headaches, there’s a higher chance you might too. Certain genes that affect brain cell ion channels make some people more prone to cortical spreading depression.
• Brain chemistry and triggers: Hormones, stress, sleep patterns, and certain foods can influence how often the aura phase shows up, though they don’t directly cause it.

Knowing these triggers and processes can help give you a clearer picture of why your brain does its own thing sometimes, which puts you in a better spot to manage the symptoms when they arrive.

Common triggers and risk factors

Figuring out what sparks your migraine attacks is key to staying one step ahead. While triggers can be super personal, here’s a snapshot of the usual suspects:

• Hormonal shifts: Changes during your period, pregnancy, or menopause can spark migraines. For those using hormonal birth control, progestin-only options like Slynd (drospirenone) or norethindrone minis like Micronor, Camila, and Nora-BE are often friendlier for migraine with aura.
• Stress and sleep: Life stressors trigger hormonal changes that can lead to aura and headache. Sleep patterns matter too. Too little or even too much sleep can set off an attack.
• Food and drinks: Some classic culprits include aged cheeses, processed meats, chocolate, and MSG. Alcohol (especially red wine) and caffeine can also tip the scales, but research isn’t conclusive yet and this differs for everyone!. Skipping meals or fasting messes with your blood sugar, which may also trigger migraines.
• Environment: Bright lights, strong smells, and even weather changes can spark attacks for sensitive brains.
• Medical and medication factors: People with cardiovascular disease, high blood pressure, or a history of stroke may have a higher risk of migraine complications. Estrogen-containing birth control pills can increase stroke risk for those who get migraine with aura, so it’s worth chatting with a healthcare professional about safer options.

Knowing your triggers doesn’t mean you can control everything, but it gives you the upper hand to plan, adapt, and feel more in control of your health.

Wisp treatment options are available only after consultation with a licensed medical professional. You should consult with your healthcare provider before starting a new supplement or treatment regimen. Individual results may vary.

How to manage an aura episode

Catching the first signs of an aura gives you a head start on handling your migraine. Finding a quiet, dark space may help reduce sensory overload, and many people swear by lying down with a cold compress on the forehead during the aura phase.

Medication for relief

Timing is everything when it comes to migraine meds:

• Triptans work best once the headache starts, not during the aura. Taking them too early can make them less effective.
• Over-the-counter pain relievers like ibuprofen or naproxen can help if taken early enough.
• Anti-nausea meds are your friend if vomiting strikes.
• CGRP antagonists are newer meds that can stop an attack during the aura.
• Beta blockers and calcium channel blockers may help with prevention, but won’t ease an acute migraine.

An online migraine consult can help you determine which kinds of meds will be right for you and your needs.

Calming at-home techniques

If you don’t have any meds handy, or want to try a natural route first, deep breathing can help calm your nervous system and ease the anxiety that often comes with knowing a migraine is on its way. Pair that with progressive muscle relaxation to release tension from your shoulders, neck, and back, and you may feel a difference. Gentle neck stretches and shoulder rolls can help loosen tight muscles that often accompany migraines.

Some people like applying peppermint oil to their temples for a cooling, soothing sensation, while sipping water throughout the aura phase can help keep you hydrated, which can make a surprising difference in how you feel.

Small, calming rituals like these don’t stop the migraine entirely, but they can help make the experience more manageable and comfortable, and give you a bit of control over how you’re feeling.

How to avoid future migraine attacks

Figuring out what works for you is the key to managing migraine with aura. Some migraine patients find that starting regular preventive strategies makes a big difference, especially if migraines show up four or more days each month. Even if your attacks are less frequent, having a plan can help you stay in control and feel less at the mercy of your headaches.

Keeping your body on a steady rhythm can help a lot. Going to bed and waking up at the same time each day stabilizes your system, while regular movement and exercise can calm the body’s stress response and lower how often migraines pop up. What you eat and when you eat can also play a role. Skipping meals or letting blood sugar swing up and down can trigger headaches, so keeping snacks and meals consistent can help you stay balanced.

Some people find medication supports their goals, too. Options include:

• Tricyclic antidepressants like amitriptyline, which can tone down how often migraines appear, even at lower doses
• Beta blockers, which help regulate blood vessels and nervous system activity
• Certain anti-seizure medications, which work for both occasional and chronic migraine patterns

If you’re thinking about contraception while managing migraines with aura, hormone-free options are often the most headache-friendly.

The ParaGard copper IUD offers long-term coverage without hormones, while barrier methods like condoms from trusted brands or the Caya diaphragm give reliable control without messing with migraine patterns.

Migraine pain doesn't get to boss you around

Managing migraine with aura gets a whole lot easier once you know your triggers, spot the early warning signs, and have your go-to treatments ready. Those visual flashes, tingling sensations, and other aura cues are basically your body giving you a heads-up, so you can get ahead of the headache rather than feeling blindsided.

If hormones are part of your migraine story, estrogen-free options like levonorgestrel IUDs—Mirena, Kyleena, Skyla, and Liletta—give you control without raising stroke risk. Pairing the right contraception with regular symptom check-ins, consistent daily habits, and staying in the know about treatment options can help you stay on top of things.

Wisp makes it easy to take control with our online migraine consultations and treatments for both immediate relief and preventative care. We’ve got your back so you can focus on living your life without headaches holding you hostage.

This blog post is for informational and educational purposes only and should not be taken as professional advice. Always consult with a qualified professional before making any decisions based on the information provided here.

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