A migraine is much more than a headache. It occurs on average one to four times a month. Unlike a tension headache, it is often accompanied by nausea or vomiting. Its pain is intensified by physical activity and is so severe it interferes with daily activities. About 30 percent of migraineurs — people with migraine — have a warning that consists of neurologic signs, or auras, they experience before the migraine episode begins. The most commonly experienced aura is visual, during which patients see small, colored dots, flashing bright lights or multicolored zigzag lines that may form a shimmering crescent-like shape. Sometimes there are blind spots in the visual field.
Aura symptoms last for 20 to 30 minutes. They are followed within five to 60 minutes by the headache. An aura shorter than five minutes may be something else, so we do not diagnose a patient with short auras as having migraine with aura. Aura symptoms that last more than one hour may be a sign of other neurological problems and should be brought to a physician’s attention. The headache that follows the aura is similar to a migraine headache without aura but often milder in intensity.