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Can an aura occur without a migraine?

The aura of the migraine is a very interesting and complicated process, and it is still a subject of debates and clinical studies. Aura is a part of the migraine process, which is ultimately due to an abnormal energy metabolism of the cortical neurons in patients with migraine with aura. Migraine with visual aura is the most common type, but it may also involve abnormal sensation, changes in speech or in rare cases of hemiplegic migraine, it may result in a paralysis of one side of the body.

A migraine with aura is distinguished by the occurrence of two attacks with at least three of these four characteristics:

  • Headache is accompanied by one or more aura symptom; aura symptoms disappear after the headache.
  • Headache is accompanied by either one aura symptom that develops gradually over 5 minutes or by two or more symptoms that occur in succession.
  • No aura symptom lasts more than 60 minutes.
  • Headache pain may follow aura within 60 minutes or appear simultaneously with aura.

Migraine without aura is defined according to the occurrence of at least five attacks, with each attack lasting 4 to 72 hours and including two of these four characteristics:

  • Pain on one side of the head (unilateral)
  • Pulsating or throbbing pain
  • Moderate to severe intensity (inhibits or prohibits daily activities)
  • Routine physical activity, such as walking up stairs, intensifies the pain

Furthermore, for the headache to be classified as a migraine headache, the headache sufferer must also experience nausea and/or vomiting or unusual sensitivity to light and sound. All symptoms may be present.

Dr. Dawn Marcus
Neurologist

Sometimes aura symptoms can occur without a headache. This is often seen in older people—especially after age 40. This is called aura without migraine, or acephalgic migraine. Auras can be frightening because they are so unusual. Many people fear they are having a stroke. If there's a change in your aura or you develop a new aura, be sure to see your doctor.

An aura with migraine is a temporary abnormality of nerve function that typically lasts for 5 minutes to an hour. Auras occur in about 10 to 20 percent of people with migraine, or up to one in five migraine sufferers. The aura typically starts about one-half to one hour before the headache phase; however, auras can also occur after the headache phase has started.

Auras most commonly involve changes in vision, but many other nerve functions may be affected. Common aura symptoms include:

  • Vision changes: flashing lights, zigzag lines, blurry vision, blind spots or black holes, distorted images
  • Numbness on one side of the body
  • Weakness on one side of the body
  • Dizziness
  • Confusion

One of the more interesting visual aura symptoms is a peculiar distortion of visual images called metamorphopsia, or change in the perception of size. During metamorphopsia, what migraine sufferers see is distorted, with some parts of objects appearing too big and others too small. Headache experts believe that Lewis Carroll must have been inspired by his own metamorphopsia when he wrote about Alice seeing things get bigger and smaller in Through the Looking Glass.

The Woman's Migraine Toolkit: Managing Your Headaches from Puberty to Menopause (A DiaMedica Guide to Optimum Wellness)

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The Woman's Migraine Toolkit: Managing Your Headaches from Puberty to Menopause (A DiaMedica Guide to Optimum Wellness)

Migraines are a common, controllable type of headache that affects one in every six women, more than 20 million in the United States alone. The Woman’s Migraine Toolkit helps readers take charge of...

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.