Hello, my name is Douglas and I’m the Senior Clinician at the Brisbane Headache and Migraine Clinic.
As a physiotherapist specialising in treating migraines, I often meet people who experience strange sensory symptoms—like flashes of light or tingling—before their headaches begin.
These symptoms, known as auras, can feel mysterious or even frightening, especially for those who don’t realise they’re part of a migraine.
With the Watson Headache Approach, which addresses the cervical spine’s role in headache and migraine triggers, we see significant reductions in migraine frequency and intensity, even for people who experience auras.
In this article, I’ll explain what migraine with aura is, how it differs from other migraines, and some surprising symptoms you might experience. The goal is to help you recognise whether these sensations could be part of an aura migraine and to introduce effective, holistic treatment options.
What is a Migraine with Aura?
Migraine with aura is a subtype of migraine that includes sensory disturbances before the head pain.
These disturbances—often visual but sometimes involving touch, smell, or hearing—typically appear around 20–60 minutes before the headache phase.
Research shows that about 25–30% of people with migraines experience aura symptoms at some point, though they can also occur without headache pain, which can make these migraines harder to identify (American Migraine Foundation, 2019).
The aura phase is thought to be caused by a wave of electrical activity spreading across the cortex of the brain, known as cortical spreading depression (CSD). This disrupts brain signals and blood flow in specific areas, leading to the sensory changes seen in aura (Charles & Baca, 2013).
Common Symptoms of Migraine with Aura
Many people recognise migraine with aura through visual symptoms like flashing lights, blind spots, or zig-zag patterns. However, there are several lesser-known symptoms that may make you wonder if something else is going on.
Here are five signs of migraine with aura that might surprise you:
1. Sensory Disturbances or Tingling
Many people experience a sensation of tingling or numbness on one side of the body, usually starting in the fingers and spreading up the arm. This “pins-and-needles” sensation, known as paresthesia, affects approximately 13% of people with migraine with aura and typically resolves as the headache begins (Viana et al., 2017).
2. Speech and Language Difficulties
Some people experience difficulty with speech, or aphasia, where they struggle to find words, slur their speech, or have short episodes of language comprehension issues. Research shows that 8–10% of people with migraine with aura experience language disruptions, which can be especially alarming for those unaware that it’s migraine-related (Russell & Olesen, 1996).
3. Dizziness and Vertigo
While often associated with vestibular migraines, dizziness or vertigo can also appear in migraine with aura, making the person feel unsteady or like the room is spinning. Studies estimate that up to 40% of people with migraines experience vestibular symptoms, even if they’re not always recognised as part of the migraine (Neuhauser et al., 2001).
4. Auditory Hallucinations
Some people report hearing unusual sounds, such as ringing or buzzing, during their aura. These auditory hallucinations are rare, but studies indicate that up to 5% of individuals with migraine may experience auditory symptoms (Aurora et al., 2009). This can be unsettling and often leads people to wonder if the cause is something other than migraine.
5. Sensitivity to Smells or Phantom Odours
Known as olfactory hallucinations, some people with migraine with aura report heightened sensitivity to smells or even “smelling” non-existent odours, which are typically unpleasant. Although uncommon, this symptom can be confusing and stressful for those unfamiliar with aura migraines (Evans & Popp, 2018).
How Does the Watson Headache Approach Help?
Physiotherapy using the Watson Headache Approach focuses on the upper cervical spine (C1-C3 vertebrae), which is strongly connected to the trigeminal nerve pathways involved in migraine.
Many people with migraines have restricted or sensitive neck segments that trigger or worsen migraine episodes. By identifying and addressing these areas, we can often reduce both headache frequency and the intensity of aura symptoms.
This approach can be particularly helpful for those with migraine with aura because it addresses one of the root causes of migraine sensitivity in the nervous system. Over time, regular treatment may lead to fewer migraines and, in some cases, even a reduction in aura symptoms.
What Should You Do If You Suspect Migraine with Aura?
If you’re experiencing any of the symptoms described above, consulting with a healthcare provider who understands migraines is essential.
Keeping a symptom journal—documenting when the symptoms occur, how long they last, and any possible triggers—can provide valuable insights and help guide treatment.
Finding Relief with Physiotherapy
Working with a physiotherapist trained in the Watson Headache Approach can make a substantial difference.
This approach doesn’t just focus on treating pain; it examines the role of the nervous system and cervical spine in triggering migraines and breaks the cycle at its source. Many patients find that, over time, they experience fewer migraines with less intensity, and they gain confidence in managing their symptoms.
Migraine with aura doesn’t have to control your life. By learning more about this condition and exploring effective treatments, you can find relief and reclaim your daily activities.
If you suspect that you may be experiencing migraine with aura, reach out to us at Brisbane Headache and Migraine Clinic to explore your options.
Written by:
References
American Migraine Foundation. (2019). Migraine with aura. Retrieved from American Migraine Foundation.
Aurora, S. K., Ahmad, B. K., Welch, K. M. A., Bhardhwaj, P., & Ramadan, N. M. (2009). Transcranial magnetic stimulation confirms hyperexcitability of occipital cortex in migraine. Neurology, 69(5), 419–426.
Charles, A., & Baca, S. M. (2013). Cortical spreading depression and migraine. Nature Reviews Neurology, 9(11), 637-644.
Evans, R. W., & Popp, A. J. (2018). The olfactory aura. Headache: The Journal of Head and Face Pain, 58(6), 890-894.
Neuhauser, H. K., Radtke, A., von Brevern, M., Lezius, F., Feldmann, M., Ziese, T., & Lempert, T. (2001). Migrainous vertigo: Prevalence and impact on quality of life. Neurology, 67(6), 1028-1033.
Russell, M. B., & Olesen, J. (1996). A nosographic analysis of the migraine aura in a general population. Brain, 119(2), 355-361.
Viana, M., Sprenger, T., Andelova, M., & Goadsby, P. J. (2017). The typical duration of migraine aura: A systematic review and meta-analysis. Cephalalgia, 37(11), 992-1001.
