When you have long-term migraine, it's about much more than a headache. You may feel sick to your stomach and find it hard to handle light, sounds, and smells. For some folks, though, it doesn't stop there. They also get something called an aura.

Most often, an aura causes you to see strange things, like colored spots or flashing lights. It can be pretty scary, especially the first time it happens.

Migraines without auras are much more common than any other kind. You can get them as often as several times a week or as little as once a year.

Auras show up in about 1 in 3 people with migraine, but you're not likely to get them every time. So it's possible you might have both types of migraine, with auras happening here and there.

How Are They Different?

In both, you get the typical migraine symptoms, which may last anywhere from a few hours to a few days. That can include:

  • Being sensitive to light, smells, sound, and touch
  • Blurred vision
  • Pain that's usually on one side of the head and worse when you move
  • Stomach upset and throwing up
  • Stiffness in your shoulders and neck

The difference is whether or not you get an aura. When you do, it typically sets in slowly over 5 to 20 minutes. It may last up to an hour. It often acts as a warning sign, coming on before any pain shows up. But it can happen during the migraine as well.

Visual auras. These are the most common ones. You might see bizarre shapes or effects that grow or move, such as:

  • Blind spots
  • Colored spots
  • Flashes of light
  • Sparkles and stars
  • Tunnel vision
  • Zigzags

Other auras. Less often, they can affect your other senses and even your ability to move. You might have:

  • Confusion and a hard time understanding people
  • Movements you can't control, like sudden jerks
  • Muscle weakness
  • Music or noises in your head that aren't really there
  • Pins and needles that start in your fingers or arm and spread to your face
  • Speech problems, as if you know what you want to say but can't form the words

But these may also be symptoms of a stroke. If you have any of them, and your doctor has not already told you that they are a part of your migraine, call 911.

Sometimes you can get an aura without any other symptoms. That's called a silent migraine. It's more common in people 50 and older.

Do I Need Different Tests?

With any kind of migraine, your doctor may do tests to check for other problems that could cause your symptoms. Depending on what other symptoms you have, you may need bloodwork or imaging, like a CT or MRI.

When you have migraine with aura, in some cases the symptoms can look like a more serious condition, such as a stroke or a seizure. To rule those out, you may get some extra tests, including an eye exam. You might also be more likely to get imaging done.

Once you've made sure there are no other issues, you don't need to see your doctor every time you have that same aura. But if your symptoms change, make sure to check in.

The first time you get an aura, it's important to get emergency care to see what's going on.

Are They Treated Differently?

They're really not. Doctors aren't sure what causes auras, so there's nothing special you can do about them. It's really about treating the migraine, and that'll be the same whether you have auras or not.

That usually means taking medicine when the migraine comes on during the aura phase. You might use over-the-counter pain relievers or prescription drugs, such as triptans or ergots. You may also take meds to help prevent migraines, depending on how often you get them and how bad they are.

Lifestyle changes, like managing stress and taking care of your overall health, can help, whether you get auras or not.

Migraine and Stroke

Another difference between the two is that migraine with aura just slightly bumps up your chances of getting a stroke. This is especially important to know for women who take birth control pills, get hormone replacement therapy, or smoke, since these things, along with migraine with aura, can raise your odds of a stroke even more.

If you have migraine with aura, work with your doctor to understand how you can lower the chances you'll get a stroke. And keep in mind that an aura usually goes away when the migraine shows up. If it lasts more than an hour, get emergency help.

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