Heeding Migraine Aura

December 8, 2016

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An Early Warning
Those who suffer from migraine know all too well what Allan describes in his post. Allan writes a blog for the Migraine Research Foundation, a non-profit company dedicated to increasing the understanding and treatment of migraine. In one post, he uses a dark, poetic language to let his readers know what auras look and feel like. Auras create sensations such as distorted vision, an increased sensitivity to stimuli like smells and sounds, and can even change a person’s speech and short-term memory. Auras occur in 15-20% of all migraine cases. For many, this phenomenon brings a state of anxiety; it signifies the coming hours, if not days, of what might be another excruciating experience. Allan felt this. Auras were, as he writes, “a cruel forewarning that migraine is on the way.” 

According to individual accounts, how an aura looks or feels like varies widely. Allan describes his own aura as if it came on in distinct stages. His auras begin with “a slight grayish speckling in my field of vision” that “grows to the center and causes a near uncontrollable blinking response.” Allan knew it was then that the “true aura” would appear. This was “a slight flashing of color far down and to the left in my peripheral vision.” At its most intense, the aura was, “a pulsating wriggling snake which flickers and sparkles with colors similar to a churning kaleidoscope.” Terrifying.

As Allan’s auras progress, his sense of shape and color become severely compromised. “My full scale of color perception changes into colors previously and normally unseen” he writes, “In some cases, most common colors are replaced with lighter or darker shades of their true selves.”

The Anatomy of an Aura
So what’s actually happening that Allan so vividly describes? While there is still no final answer to that question, researchers are increasingly attributing it to a phenomenon called “cortical spreading depression” (CSD).

CSD is similar to experiencing a seizure. It affects the electro-chemistry of the brain in the same way, which explains the intense coordinated behavior in specific areas. Instead of brain cells firing as they normally would, whole regions go “dark” after a period of hyper-stimulation. Medical examination bears this out. If you were to look at a scan of a brain experiencing CSD, you’d see an abnormal excitation of neurons in specific areas, followed by a lack of activity. These temporary irregularities by brain cells disrupt their normal processing.

To put it in a different way, think of your brain cells as workers with a task to carry out. When aura occurs, these workers who know exactly their job, and how to do it, all of a sudden temporarily forget the tasks they’ve done countless times. 

As these affected parts of the brain struggle to get back to work as usual, the person experiences blurriness and lack of vision which skews perception, making everday objects foreign.

It should be noted there is some debate as to whether CSD is, in fact, always the culprit. Alternate models have been proposed. Yet, according to Dr. Turgay, Dr. Nozari and Dr. Moskowitz, three of the leading researchers in the field, the consensus is growing that CSD is “the most likely explanation for migraine visual aura” (see reference #3).

A Clear Vision for the Future
Outside of the laboratories, clinics, and hospitals—and regardless of what causes them—auras can be threatening and foreboding. Whether you’re taking medication for the condition or approaching it through other means, early detection of an attack makes it much easier to deal with. It seems clear Allan knows this. It’s important that you develop this awareness of triggers, and your brain’s response, as well.   

If you have migraine, there are a number of successful treatment approaches. Learn about them by talking to one of our Patient Care Managers at Migraine Treatment Centers of America: (855) 980-7530.                

References

  1. Migraine Research Foundation. ‘Allan’. 2016. Accessed November 25, 2016. https://migraineresearchfoundation.org/our-community/migraine-stories/allan/.
  2. ‘Migraine Variants: Overview, Pathophysiology, Epidemiology’. November 3, 2016. Accessed November 25, 2016. http://emedicine.medscape.com/article/1142731-overview.
  3. Dalkara, Turgay, Ala Nozari, and Michael A Moskowitz. ‘Migraine Aura Pathophysiology: The Role of Blood Vessels and Microembolisation’. Lancet Neurology 9, no. 3 (March 2010): 309–17. Accessed November 25, 2016. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2921876/.
  4. Costa, Cinzia, Alessandro Tozzi, Letizia Maria Cupini, Paolo Calabresi, Cenk Ayata, and Paola Sarchelli. ‘Cortical Spreading Depression as a Target for Anti-Migraine Agents’. The Journal of Headache and Pain14, no. 1 (July 23, 2013): 62. Accessed November 26, 2016. doi:10.1186/1129-2377-14-62. https://thejournalofheadacheandpain.springeropen.com/articles/10.1186/1129-2377-14-62.

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