Visual Aura / Scintillating Scotoma – Migraines

 
          Normal Vision                   Vision with Scintillating Scotoma

Some people with migraines (less than one in four) may present “aura”, which sometimes precedes the headaches. Usually, people with migraines falsely call “aura” an indistinct and non specific sense that a migraine crisis is coming. The term “aura”, however, refers to something completely different: “Aura” in migraines is some particular neurological symptoms (of the vision, the senses, movement or speech) that usually precede pain.

The most common aura consists of visual symptoms (visual aura). The person with visual aura might often see bright lines, lights that flicker or blurry segments in his visual field (these symptoms are merely indicative, since there are many types of visual aura). It is usual that the symptoms coexist: a line, bright or not, that may flicker has on one of its sides an area that is not clear (this is called “scintillating scotoma”). The symptoms of visual aura can be found in part of the visual field (right or left), something that makes the person who has them think that they are in one eye (right or left). The visual aura symptoms move within the visual field, more often from the center to the outside. If they can be found in half the visual field, it is often described as “faces and objects seem half”. This lasts less than an hour and often for only 15 or 20 minutes. Migraine headache usually follows the aura, but in some cases it may come before or at the same time.

Besides visual symptoms, some people have sensory aura (“pins and needles”) in one part of the body. Sensory aura usually includes the hand and the head on the same side. Other people experience speech problems as part of their aura (they can't find words or even speak).

Even though the aura symptoms can be (at least, initially) scary for some people, they are generally harmless and people with migraines and aura may experience them many times in the course of their lives. However, such symptoms should be reported, in any case, to a neurologist to make sure that they are not caused by something else.