There are different types of migraines, or rather, different manifestations of the same underlying migraine disease. While it’s mistakenly thought of as the only type of migraine, a migraine with aura is only one of the ways this illness makes itself felt. The aura is known to involve visual effects, but not many people realize that it’s actually a wider neurological phenomenon that affects more than the vision. Not every migraine sufferer experiences the aura, but those who do can have much broader symptoms than just visual ones.
It’s true that the effects most generally associated with the migraine with aura are related to vision. People might experience blind spots or see jagged light flashes or have an image split into shards. But for an hour or so prior to the severe headache coming onto the scene, the aura can produce other neurological effects as well, like tingling in the limbs or face, extra sensitivity to light or touch, and even slurring of speech. Since it’s the nerves that are affected, and not the eyes directly, visual symptoms are just one kind of result of the extra nerve sensitivity.
Another type of migraine is sometimes mistaken for one with the aura, which is the ocular or ophthalmic migraine. This has similar visual symptoms to the standard aura, involving blind spots in the vision, as well as zigzagging or brightly flickering light. This type of migraine, though, might occur without a headache at all, as the phenomena originates in the blood vessels of the retina rather than in the occipital cortex, the area of the brain that processes vision (where the aura originates). So there is some debate about whether this is a migraine with aura at all, yet many doctors argue that the otherwise unexplained disturbances in the retinal blood vessels must also surely originate in the occipital cortex.
Whether these visual and other phenomena are caused by one type of migraine or two can be debated, but the discussion doesn’t actually change the migraine management itself. All preventive measures and drugs will be the same in either case. Possibly the greatest difference between a migraine with aura and one without is that the migraine sufferer has more advance warning of the headache. While this might give them more time to prepare and try to nip it in the bud, the aura can also be discouraging, as the person in essence watches the migraine coming from a distance, and has that extra time to dread its approach.
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