Treatment Options For Migraine With Aura
Your treatment options depend on how often you have attacks and how severe they are. It will also depend on other factors such as other illnesses you may have or medication that you take.
Generally, treatment for migraine includes:
- Acute treatment such as over the counter painkillers, migraine specific treatments and anti-sickness medication. These treatments aim to help manage the symptoms when an attack comes on. You do need to be careful not to take certain acute treatments too many days a month as this can cause medication overuse headache.
- Preventive treatment such as beta-blockers, tricyclic antidepressants or anti-epilepsy drugs. These treatments aim to reduce how often you have migraine attacks and how bad they are. You take them every day and build them up to an effective dose. Some people need to try a range of treatments, or may be referred to a specialist if the treatments dont work for them.
Alongside the treatments many people benefit from reviewing whether lifestyle changes can help with their migraine attacks. This can include things like sticking to a routine, waking up at the same time each day, eating at similar times each day and staying hydrated. If there are factors such as alcohol or lack of sleep that seem to trigger your migraine attacks, there might be changes that you can make to help reduce how often you have attacks.
Eat And Sleep On A Regular Schedule
Fasting or skipping meals can trigger migraine headaches. Make sure you eat within an hour of waking up and then every three to four hours. Hunger and dehydration both cause migraines. Make sure youre drinking enough water, and never skip a meal.
Lack of sleep can also aggravate symptoms, so make sure you clock in at least seven to eight hours. Even getting too much sleep can cause headaches, so dont try to make up for lost sleep by snoozing too long.
What Causes A Migraine
Although migraines are extremely common, their exact cause remains unknown. It appears likely that the visual aura relates to a phenomenon called cortical spreading depression which temporarily affects electrical impulses in the brain. The pain of a migraine headache probably relates to spasm or irritability of blood vessels in the brain, which are sensitive to pain . Beyond these hypotheses, however, the exact mechanism that triggers a migraine remains unknown.
It is often possible to identify certain risk factors that increase the chance of having migraines. A positive family history is very common, so the doctor will often ask about headaches in ones parents or siblings. Overall, migraines are more common in women than in men. In addition, a persons hormonal status can affect the pattern of migraines they experience; therefore, it is natural for a woman to notice a change in headaches and other migraine symptoms in adolescence or around the time of menopause.
Many individuals can identify specific triggers for their migraines. These triggers include fatigue, skipping a meal, caffeine withdrawal, stress, and certain foods . For many patients with isolated visual migraines, however, the events can be very infrequent and no definite trigger can be determined.
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Try Hot Or Cold Therapy
If youve ever put an ice pack on an injury or a heating pad on a sore back, you know the power of temperature therapy. This can also help when you have a migraine. You may need to experiment to decide what feels best for you. Some people find that an ice pack applied to the head offers soothing, numbing relief. This is particularly helpful if sun or heat brought on your migraine.
Other people find a heating pad or hot shower to be therapeutic during an attack. Its worth trying hot or cold therapy when your next migraine hits. It can safely and effectively complement your medication.
Treatment Of Migraine With Aura
When you get treated for migraine with aura, the main goal is to prevent and manage pain.
Your doctor may suggest medications to prevent migraine with aura, including:
Your doctor may also suggest you take magnesium or riboflavin to prevent migraine with aura.
Your doctor may also suggest prescription drugs called triptans and ergotamines. If the pain is severe, you may need to get treatment in an emergency room with medications you take through an IV.
If you are vomiting, your doctor may recommend anti-nausea drugs.
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How To Stop A Migraine In Its Tracks
- Some migraine sufferers report noticing small changes in their body 1-2 days before the migraine begins including constipation, diarrhea, depression, irritability, food cravings, or a stiff neck. This is called the Prodrome Stage.
- Sometimes migraine sufferers will receive a warning symptom such as a flash of light, visual disturbance, blind spot, bright spot, speech problem, or tingling in an arm or leg. This warning is called the Aura Stage. At other times, there is no pre-warning.
- The Attack Stage comes next with the a painful, pulsing, and throbbing head along with nausea, vomiting, blurred vision, diarrhea, and the feelings of dizziness, light-headedness and fainting.
- The final phase, Postdrome, often leaves one feeling drained and washed out. However, others report a feeling of mild euphoria after a migraine has passed.
When You Get A Migraine
Try to treat your symptoms right away. This may help make the headache less severe. When migraine symptoms begin:
- Drink water to avoid dehydration, especially if you have vomited
- Rest in a quiet, dark room
- Place a cool cloth on your head
- Avoid smoking or drinking coffee or caffeinated drinks
- Avoid drinking alcoholic beverages
- Try to sleep
Over-the-counter pain medicines, such as acetaminophen, ibuprofen, or aspirin, are often helpful when your migraine is mild.
Your health care provider may have prescribed medicines to stop a migraine. These drugs come in different forms. They may come as a nasal spray, rectal suppository, or injection instead of pills. Other medicines can treat nausea and vomiting.
Follow your provider’s instructions about how to take all of your medicines. Rebound headaches are headaches that keep coming back. They can occur from overuse of pain medicine. If you take pain medicine more than 3 days a week on a regular basis, you can develop rebound headaches.
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What About Ocular Optical & Ophthalmic Migraine
You might have heard about ocular migraine, optical migraine or even ophthalmic migraine. These are terms which may be used to describe your migraine condition by others but they are not formally recognized migraine classifications by the International Headache Society or the International Classification of Headache Disorders.
Often these are terms used by individuals or doctors who are not aware of the ICHD classifications . The terms are essentially translated to eye or eye-related migraines which isnt a particularly helpful diagnosis. The reality is many general doctors may not aware of the globally recognized standard of migraine classifications.
There is no classification for ocular, optical or ophthalmic migraine under the current ICHD-3. When someone claims they have an ocular, optical or ophthalmic migraine, then sees a qualified doctor to get an official ICHD diagnosis it is likely to fall into one of the four types of migraine with aura discussed above.
Which type of migraine with aura will depend on the symptoms experienced and diagnosis from your doctor. Below is a symptom & classification table to help you get a headstart.
Stages Of A Migraine Attack
It is often difficult to know when a migraine attack is going to happen. However, you can often tell the pattern of each attack as there are;well defined stages.
It is these stages and their symptoms that distinguish a migraine from a headache.
However, not everyone will experience all of the symptoms of each stage and the stages can overlap. In adults, we can divide a migraine attack into four or five stages that lead on from each other.
Learning to recognise the different stages of a migraine attack can be useful. You might get one, all, or a combination of these stages, and the combination of stages may vary from attack to attack. Each stage can vary in how long and how bad it is. Recognising different symptoms at different times during your attack can give your doctor information which may help them make a diagnosis. Taking medication as soon as you notice the pain may stop or shorten an attack.
Migraine attacks in children are often much shorter than in an adult. It may be easier to tell the different headache stages in a child.
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What Is The Best Way To Treat A Migraine With Aura
When aura symptoms begin, it can be helpful to move into a quiet, dark room and close your eyes.
Placing a cold compress on your forehead or the back of your neck may also help ease ensuing migraine pain.
Like other types of migraine, treating a migraine with aura involves a combination of medications. These include medications for both prevention and relief of symptoms.
Preventive medications that may stop migraine attacks from occurring include:
- antidepressants, such as amitriptyline
- blood pressure medications, like beta-blockers or calcium channel blockers
- anti-seizure drugs, such as topiramate
Medications for symptom relief help decrease the severity of an oncoming migraine attack. Theyre typically taken as soon as the symptoms of an aura develop.
Examples of some of these medications are:
- over-the-counter pain relievers like acetaminophen or ibuprofen
- triptans, such as rizatriptan and sumatriptan
- happens after a head injury
Its also a good rule of thumb to make an appointment with your doctor for headaches that:
- happen frequently and last from hours to days
- disrupt your daily activities
- occur frequently when you used to be headache-free
If youre concerned about your migraine and dont already have a primary care provider, you can view doctors in your area through the Healthline FindCare tool.
Migraine With Aura Symptoms
Migraines with aura include additional visual and non-visual symptoms that can provide a useful warning that a headache is on its way.1
The visual aura symptoms may include:1,2
- Geometric patterns
- A shimmering effect
These may appear in the center of your field of vision and gradually spread outward.1,2 Some people also experience blind spots or tunnel vision.
Non-visual aura symptoms may include:1,2
- Tingling or numbness in the hands or face
- Dizziness or vertigo
- Difficulty with speech and/or hearing
- A sense of fear or confusion
- Partial paralysis or fainting
Auras usually develop over the course of five to 20 minutes and last fewer than 60 minutes. The head pain and other symptoms associated with classic migraines typically come after the aura, but might begin during the auraas well.1
In rare cases, you may experience the aura without a migraine following this is more common in people over the age of 50.1,2
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What Causes Persistent Migraine Aura
The cause of migraines with aura and of PMA is unknown, though the aura may be owed to a type of electrical disturbance in the brain that creates the visual changes. The triggers are similar to that of migraines without aura: stress, hormonal changes, certain foods, bright light, and not getting enough sleep.
Common Visual Disturbances Include:
- Distortions in the size & shape of objects.
- Vibrating visual field.
- Shimmering pulsating patches or curves.`
Other aura sensations include:
- Abdominal symptoms such as nausea or a rising sensation in the stomach.
- Sudden anxiety or fear.
- Feeling separated from your body.
- Sensation of limbs or teeth growing.
- Feeling overheated.
- Confusion, reduced mental cognition, forgetting common words or how to do simple tasks.
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Get Your Beauty Sleep
Catching enough zzzs is critical for keeping migraines at bay. A sleep-deprived week followed by a Saturday spent sleeping-in could have the potential to ruin your weekend with a headache. Dr. McCawley recommends staying in a routine by going to bed at the same time every night and waking up at the same time every morning.
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Helpful Supplements For Preventing Migraines
10) Try Butterbur experts suggest that this herb may help to prevent migraines as it helps blood flow healthily around the body including to the brain.
11) Take Feverfew supplementation this is a remedy that may help to stop migraines before they occur. In studies, feverfew has resulted in a lower number of headaches and minimized pain when taking the supplement.
12) Magnesium often works as a migraine prevention remedy magnesium is an essential nutrient in the body and is available in high levels in certain spices, cereals, nuts, leafy vegetables, tea, and coffee. Experts say that during a migraine attack the brain suffers from low levels of magnesium, therefore, they say that taking magnesium is effective to prevent migraines from occurring as it lowers the risk of magnesium deficiency. In most cases it is recommended to take magnesium at high doses over a relatively long period of time.
13) Use Coenzyme Q10 this is like a vitamin and is available in supplement form. It is an antioxidant and can also help to reduce the number of days with a migraine by up to 50 percent, according to some studies. It may also help to reduce the severity of migraine headaches.
14) Try riboflavin this is also known as vitamin B2. It is also useful as an antioxidant. You can get riboflavin from eggs and lean meat, nuts, dairy, and legumes. It has been studied, and participants in trials have experienced fewer migraines and less severe migraines when taking riboflavin.
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Implications For Future Trials
Patients with migraine with aura, may have attacks with and without aura and most had more than one subtype of migraine with aura . Even though few patients report only MA, the group having both MO and MA is often substantial, and is it therefore important to classify each individual attack being treated according to the International Classification of Headache Disorders, as suggested by the International Headache Society clinical trials subcommittee . The trials of tonerbasat showed efficacy in migraine with aura, but not in migraine without aura, suggesting that migraine with and without aura should be studied separately .
Trials of migraine prophylactic drugs generally focus on reduction in the number of migraine days as the key efficacy parameter, and little attention has been paid to the influence of these drugs on the occurrence of auras.
Future studies should have a clear distinction between aura and non-aura headaches. Other modifying factors, as attack frequency and treatment is also needed to understand how imaging changes is related to clinical outcomes.
What Are Some Migraine Risk Factors And Triggers
Some things make you more likely to get migraine headaches . Other things may bring on a migraine .
Common migraine risk factors include the following:
- Family history: You are much more likely to have migraines if one or both of your parents had migraines.
- Sex: Women are more likely than men to have migraines.
- Age: Most people have their first migraine during adolescence, but migraines can start at any age, usually before age 40.
Common migraine triggers include the following:
- Food and drink: Certain food and drink may cause migraines. Dehydration and dieting or skipping meals may also trigger migraines.
- Hormone changes: Women may experience migraines related to their menstrual cycles, to menopause, or to using hormonal birth control or hormone replacement therapy.
- Stress: Stress may trigger migraines. Stress includes feeling overwhelmed at home or work, but your body can also be stressed if you exercise too much or dont get enough sleep.
- Senses: Loud sounds, bright lights , or strong smells may trigger migraines.
- Medicines: Certain medicines may trigger migraines. If you think your migraines might be related to your medicine, talk to your doctor. Your doctor may be able to prescribe a different medicine.
- Illness: Infections, such as the cold or the flu, may trigger migraines, especially in children.
Foods that may trigger migraines:
- aged, canned, cured, or processed meat
- aged cheese
- soy sauce
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Can You Have An Aura Without A Headache
Its possible for an aura to occur without a migraine headache. This is called silent migraine. Although the migraine pain doesnt occur, the aura symptoms themselves can still be disruptive to daily activities.
Ocular migraine, a type of migraine attack characterized by visual symptoms, can sometimes occur without pain. Migraine with aura and retinal migraine are sometimes considered types of ocular migraine.
Migraine attacks that occur without pain may sometimes be diagnosed as transient ischemic attacks or seizures due to the symptoms being so similar.
Migraine With Aura Prevention
If other treatments donât work and you have 4 or more migraine days a month, your doctor may suggest preventive medicines. You take these regularly to make migraines less strong or happen less often. These include seizure medicines, blood pressure medicines , and some antidepressants. A new class of preventive medicine called CGRP inhibitors may also help.
Your doctor can also prescribe a device, Cefaly, that uses a method called transcutaneous supraorbital nerve stimulation. You wear it as a headband on your forehead and turn it on daily for 20 minutes to prevent migraines.
Avoid your triggers. Common ones include:
- Certain foods
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What Are The Acute Treatments For Migraine
An isolated visual migraine, without headache, typically does not require any acute treatment, since the visual symptoms resolve on their own fairly quickly. The first few times someone experiences a visual migraine it usually causes a lot of anxiety. Once someone has become familiar with the symptoms of a visual migraine, new episodes no longer cause the same level of anxiety.
It can be helpful to try to rest during the episode. Some patients benefit from other strategies, including eating something, having caffeine, or taking an over-the-counter medication such as acetaminophen or ibuprofen .
Patients in whom the visual symptoms are accompanied by a severe headache often benefit from additional therapies. The goal of these medications is to try to cut short the headache before it becomes too severe. Some patients find naproxen , which is a stronger anti-inflammatory medication, to be helpful. Other patients try a class of medications known as triptans.
Triptans are specially designed to work on receptors on blood vessels and brain cells in order to halt a migraine at an early stage. Although there are a number of different triptans, made by several different pharmaceutical companies, each of these is approximately equally effective. Triptans are often taken orally, but also come as injections and nasal sprays. These medicines are generally not considered safe in patients with a history of strokes, heart attacks, or other vascular diseases.