Summary about Disease
Aura, in the context of migraines or seizures, refers to a sensory disturbance that precedes the headache or seizure itself. It can manifest in various forms, including visual disturbances (like flashing lights or zig-zag lines), sensory changes (numbness or tingling), motor weakness, or speech difficulties. Not everyone with migraines or epilepsy experiences auras. Auras typically last a short period, ranging from a few minutes to an hour, and then resolve, often followed by the main event (headache or seizure).
Symptoms
Aura symptoms vary widely depending on the individual and the type of aura. Common symptoms include:
Visual: Flashing lights, shimmering spots, zig-zag lines, blurred vision, partial vision loss (scotoma).
Sensory: Numbness, tingling (often starting in the hand and moving up the arm or face), pins and needles sensation.
Motor: Weakness in an arm or leg, difficulty with coordination.
Speech/Language: Difficulty finding words, slurred speech, inability to understand language (aphasia).
Other: Auditory hallucinations (hearing sounds that aren't there), olfactory hallucinations (smelling odors that aren't present), dizziness, vertigo.
Causes
The exact causes of auras are not fully understood, but they are believed to be related to electrical and chemical changes in the brain. In the context of migraines, it is thought that a wave of electrical activity, known as cortical spreading depression, moves across the brain and causes temporary dysfunction. In the context of epilepsy, auras are focal seizures, resulting from abnormal electrical activity in a specific area of the brain. Factors that may trigger migraines with aura include:
Stress
Lack of sleep
Certain foods (aged cheese, processed meats, caffeine withdrawal)
Alcohol
Hormonal changes (in women)
Sensory stimuli (bright lights, loud noises)
Weather changes
Medicine Used
There isn't a specific medication to directly treat the aura itself, as it is a transient phenomenon. Treatment focuses on managing the underlying condition, whether it's migraine or epilepsy.
Migraines with Aura: Pain relievers (NSAIDs, triptans) are used to treat the migraine headache that follows the aura. Preventative medications (beta-blockers, calcium channel blockers, antidepressants, CGRP inhibitors) may be prescribed to reduce the frequency and severity of migraine attacks.
Epilepsy with Aura: Anti-epileptic drugs (AEDs) are the primary treatment for epilepsy and help to control seizures, including those manifested as auras. The specific AED prescribed depends on the type of seizure and individual patient factors.
Is Communicable
No, auras are not communicable. They are neurological events within an individual's brain and cannot be transmitted to another person.
Precautions
If you experience auras, especially if they are new or changing, it is important to:
See a doctor: Get a proper diagnosis to rule out serious underlying conditions.
Identify triggers: Keep a diary to track potential triggers of your auras and try to avoid them.
Take medication as prescribed: If you have been prescribed medication for migraines or epilepsy, take it as directed.
Be prepared: If your auras are predictable, take steps to prepare for the headache or seizure that may follow (e.g., lie down in a quiet, dark room, notify someone nearby).
Avoid driving or operating heavy machinery during an aura, as your vision or coordination may be impaired.
How long does an outbreak last?
An "outbreak" isn't the right term. An aura itself typically lasts between 5 minutes and 1 hour. Migraines themselves can last from 4 to 72 hours. Seizures manifesting as auras usually lasts a few seconds to minutes.
How is it diagnosed?
Auras are diagnosed based on a person's description of their symptoms. A doctor will take a detailed medical history and perform a physical and neurological examination. Tests may be ordered to rule out other conditions and confirm the diagnosis:
Electroencephalogram (EEG): Measures electrical activity in the brain and can help identify seizure activity.
Magnetic resonance imaging (MRI): Provides detailed images of the brain and can help identify structural abnormalities.
Computed tomography (CT) scan: Another imaging technique that can help identify brain abnormalities.
Blood tests: To rule out other medical conditions.
Timeline of Symptoms
The timeline of symptoms is generally: 1. Prodrome (optional): Some people experience subtle changes in mood, energy level, or appetite in the hours or days before the aura. 2. Aura: Develops gradually over 5-20 minutes and lasts less than 60 minutes (typically 5-60 minutes). The specific symptoms depend on the type of aura (visual, sensory, motor, etc.). 3. Headache (for migraine with aura): Usually starts within an hour of the aura resolving, but can be delayed. The headache is typically throbbing and located on one side of the head. 4. Postdrome (for migraine with aura): After the headache subsides, some people experience a period of fatigue, confusion, or difficulty concentrating. For epilepsy, the aura is the beginning of the seizure itself.
Important Considerations
New auras: If you experience a new type of aura, or if your auras change significantly, seek medical attention promptly. This could indicate a new or worsening underlying condition.
Stroke: Some aura symptoms, particularly motor weakness or speech difficulties, can mimic stroke symptoms. It is crucial to rule out stroke, especially if the onset is sudden.
Individual variability: Aura symptoms and the associated migraine or seizure experience can vary significantly from person to person.
Management: Effective management of migraines or epilepsy can significantly reduce the frequency and severity of auras.
Differential Diagnosis: Many conditions can mimic auras, it is important to rule out other possible causes.