Migraine with aura is characterized by the appearance of transient neurological disorders before the migraine attack. These disorders are most often visual. We speak of migraine with visual aura, or ophthalmic migraine. Several preventable risk factors have been identified. Different treatment and prevention solutions are possible.

Definition of migraine with aura

Migraine with aura is different from the common migraine, called migraine without aura. A migraine is a form of headache that manifests itself in repeated attacks. These result in pain in the head which is usually one-sided and throbbing. 

The aura is a transient neurological disorder that precedes the migraine attack. Migraine with visual aura, or ophthalmic migraine, represents 90% of cases. In other cases, the migraine may be preceded by a sensory disorder or a language disorder.

Causes of migraine with aura

The origin of migraines is still poorly understood. 

In the case of migraine with aura, the activity of neurons within the brain may be disrupted. A decrease in cerebral blood flow could be one of the explanations. 

It seems that there are also genetic predispositions. More research is needed to better understand the causes of migraine with aura.

Risk factors

Observational studies have identified factors that may promote migraine attacks. Among them are in particular:

• positive or negative emotional variations;
• an unusual change in rhythm such as intense physical exertion, overwork or, conversely, relaxation;
• too little or too much sleep;
• changes in hormonal balance such as falling estrogen levels during menstruation;
• sensory changes such as a sudden change in light or the appearance of strong odors;
• climatic changes such as the arrival of heat, cold or strong wind;
• changes in eating habits such as alcohol consumption, eating too much food or an imbalance in the timing of meals.

Diagnosis of migraine with aura

A physical examination is usually sufficient to diagnose migraine with aura. It is only diagnosed after two migraine attacks with aura. No other disorder should be able to explain the onset of headaches.

People affected by migraine with aura

Migraines with aura are not the most common. They only concern 20 to 30% of migraine sufferers. With or without aura, migraines can affect anyone. However, they seem to mainly affect adults before the age of 40. Prepubertal children also seem to have a higher risk of having migraines. Finally, statistics show that women are the most prone to migraines. About 15 to 18% of women are affected compared to only 6% of men.

Neurological signs

The aura precedes the migraine attack. It can be translated by:

• visual disturbances in the majority of cases, which can be characterized in particular by the appearance of bright spots in the field of vision (scintillating scotoma);
• sensory disturbances which may manifest as tingling or numbness;
• speech disorders with difficulty or inability to speak.

These signs are warning signs of a migraine. They appear in a few minutes and last for half an hour to an hour.

Migraine

Migraine pain is different from other headaches. It has at least two of the following characteristics:

• throbbing pain;
• unilateral pain;
• moderate to severe intensity which complicates usual activities;
• pain that gets worse with movement.

The migraine attack can last between 4 hours and 72 hours if it is not taken care of.

Possible associated disorders

The migraine attack is often accompanied by:

• troubles de la concentration ;
• digestive problems, such as nausea and vomiting;
• photo-phonophobia, sensitivity to light and noise.

Several levels of treatment can be considered:

• analgesics and / or anti-inflammatory drugs at the start of a crisis;
• anti-nausea medication if necessary;
• treatment with triptans if the first treatments are not effective;
• a disease-modifying treatment which may be hormonal or rely on the intake of beta-blockers if the other treatments have proved ineffective.

To avoid the risk of recurrence, it is also recommended to take preventive measures.

Prevention consists of identifying and then avoiding the factors that may be at the origin of migraine attacks. Thus, for example, it is advisable to:

• maintain good eating habits;
• establish regular sleep schedules;
• do not neglect the warm-up before the sport;
• avoid excessively violent physical and sports activities;
• fight against stressors.