Migraine Aura without a Headache

You may experience Migraine headaches with or without auras.  Neither can be said to be less painful than the other, though the aura-less may be less frightening and stressful.

Although auras are often associated with migraines, in fact only about 20% of migraine sufferers actually experience any of the symptoms of aura.  The aura stage is part of the complex migraine pattern, following the prodome stage.  

Depending upon how extreme the aura symptoms become, the aura stage can become quite horrifying, like a bad dream or, worse, a movie sequence of a bad dream. The aura stage usually lasts less than half an hour and its symptoms and affects can vary tremendously from one migraine sufferer to another.

The aura is all about distortions in perception.  Despite the connotation of aura as a visual component, symptoms associated with auras are not limited to specifically visual distortions.  

Blurred vision, headache, congestion, ears ringing and insomnia are just a few of the characteristics associated with auras, others include:

·         partial and temporary paralysis

Changes taking place within the outermost layer of the brain, the cortex, is the cause of auras.

With the depression of activity in the nerve cells, there is a resulting impairment in the function of the body part that is controlled by those cells.  A slow spread in the depression of nerve cell activity is theorized to be the cause of the development of aura.   The symptoms gradually build up and slowly make their way from one visual region or body part to another. 

For the migraine sufferer, this means the appearance of a black spot arising in their field of vision. The black spot may also be encompassed by either flashing lights or bright lines that zig zag back and forth. The black spot will slowly, over a period of a few minutes, grow slightly larger. 

It is this combination of so-called ‘negative symptoms’ such as the loss of vision with the ‘positive symptoms’ such as zigzagging lines that make up the typically distinctive features of a migraine aura.  

The vision blackouts, the ‘negative symptoms’ are caused by a depression of nerve activity.  On the other hand, the zigzagging lines, the ‘positive symptoms’, are caused by hyperactivity in the nerve cells. 

The origin of this sequence of neurological events leading to auras and headaches is still unknown. What is known, however, is that those suffering from migraines have been found to have an ingrained susceptibility to factors that generally are not headache triggers. Migraine suffers are prone to changes in body chemistry, such as menstruation, certain foods, and dozens of environmental influences, such as a change in weather, may trigger an attack.

Migraine Headache with Aura

In order to be officially designated as a migraine with aura, the headache sufferer is required to have had at least two headaches with three out of four of the following:

·         One or more aura symptom that originated in the cerebral cortex or brain stem

·         At least one aura symptom that developed gradually over more than four minutes.  or, at least two or more aura symptoms occurring in succession

·         No single aura symptom that lasts for more than an hour. (however, it is perfectly acceptable for successive symptoms to extend that time, but each individual symptom should last no more than an hour)

·         The headache itself may begin before, at the same time, or at an interval of no more than an hour after the defined hour

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