Transitory migraine aura symptoms

Hubert Airy, Illustration of visual migraine aura, 1870.

An attack of migraine is divided into four distinct stages. This section of the website is primarily devoted to the aura phase, i.e. one of two stages that may be present before the actual headache starts.

The aura is the complex of neurological or neuropsychological symptoms, for example

Visual symptoms, i.e., visual loss, visual hallucinations, visual illusions
Motor symptoms, e.g. weakness or palsy
Somatosensory symptoms, e.g. numbness, prickling sensations, etc.
Body image disturbances, e.g. macro- and microsomatognosia (feeling larger or smaller), out-of-body experiences and felt presences
Near-death experiences
Depersonalization and derealization
Auditory symptoms, e.g. tinnitus (buzzing sounds)
Gustatory symptoms
Olfactory symptoms, e.g. hallucinations of odours and smells not actually present
Speech symptoms
Language symptoms
Paramnesias (déjà vu and jamais vu)
Forced reminiscence
Time perception disturbances
Synaesthesia
Disturbances of dreaming
Other disturbances of higher cortical functions

The typical symptoms of migraine aura are sensory phenomena that usually occur before the headache phase and propagate in sensory space. Visual auras for example, may propagate through the visual field. This feature is important for an understanding of the pathomechanisms of the migraine aura, the study of which may result in a new classification of visual disturbances (see the sections of the website edited by Markus Dahlem).

G.R., Migraine aura animation, 2009. "I thought you might like to see my version of what I see after about 45 minutes of a normal migraine aura attack. These have been occuring probably about once every couple of months for the last few years, after a gap of nearly 20 years without incident. Here is a link to the animation I have put together to show my visual disturbances shortly before the peak of an attack. I wish I experienced colour like some of the other sufferers (they look so much more fun!) but mine are monotonously in black and white. Very geometric and checker-boarded." (G.R., E-Mail to Klaus Podoll, June 4, 2009) © 2009 G.R. (larger image see here)

Frances Wilkinson (2004) argues that the visual aura has a potential value as a window on brain function, and she quotes W.R. Gowers who stressed - already in 1895 - the importance of ascertaining trustworthy facts about the aura: "The difficulty of ascertaining the facts depends on their subjectivity. That which is to be discerned can only be seen through the vision of another. Moreover, this is the sight of the unreal; it is the sight of that which is not. Yet, though unreal to the subject it is, as a sensation, a profound reality which confuses the mind and may make even recollection painful. Hence the opportunities for ascertaining trustworthy facts a very rare, and when they come it is important that they should be made the most of."

References

Gowers WR. Subjective visual sensations. Trans Ophthalmol Soc UK 1895; 15: 1-38.
Grossinger R. Migraine Auras: When the Visual World Fails. North Atlantic Books, Berkeley California 2006.
Podoll K, Robinson D. Migraine Art - The Migraine Experience from Within. North Atlantic Books, Berkeley, California 2009, p. 81-296.
Wilkinson F. Auras and other hallucinations: windows on the visual brain. Prog Brain Res 2004; 144: 305-320.

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