Migraine With Aura

Overview

Migraine with aura is a neurological condition where temporary visual, sensory or speech changes precede (or replace) the headache phase. Auras can look like zig‑zag lines, flashing lights, blind spots or tingling that spreads across one side of the body. Importantly, migraine with aura is linked to a higher lifetime risk of ischaemic stroke—especially in women who smoke or use oestrogen‑containing contraception—so proactive management matters.

At The Royal Buckinghamshire Hospital, Aylesbury you can access consultant‑led neurology clinics, rapid blood and imaging tests when indicated, and tailored lifestyle and medication plans to cut both migraine frequency and stroke risk.

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Why Early Control Matters — Stroke and Beyond

Migraine with aura roughly doubles the risk of ischaemic stroke; the risk rises further with smoking, hypertension or oestrogen therapy
Recurrent attacks disrupt work, driving and family life
Untreated nausea, light sensitivity and fatigue can lead to anxiety or low mood
Frequent painkiller use may cause medication‑overuse headache
Good control improves sleep, cognitive performance and overall wellbeing

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Symptoms You Might Notice

• Visual aura: shimmering zig‑zags, flashing lights, blind spots or distorted shapes (typically 5–60 minutes)
• Sensory aura: pins and needles or numbness marching from fingers to face
• Speech or language disturbance: slurred words or trouble finding words
• Headache: often throbbing, one‑sided, worsened by movement, with nausea and light or sound sensitivity
• Postdrome “hangover”: fatigue, fogginess or scalp tenderness after the pain settles

Red flags needing urgent attention include sudden “worst headache,” new weakness on one side, facial droop or persistent speech loss—call 999.

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Common Triggers and Risk Factors

• Stress swings, sleep deprivation or weekend “lie‑ins”
• Skipped meals, dehydration or high‑sugar snacks
• Bright or flickering lights, strong smells, loud noise
• Alcohol (especially red wine) and certain foods (aged cheese, processed meats)
• Hormonal shifts around menstruation or menopause
• Smoking, high blood pressure, high cholesterol and combined oral contraceptives (also raise stroke risk)
• Family history of migraine

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When to Seek Medical Advice

Call 01296 678 800 if you:

• Have new or changing aura symptoms, especially after age 40
• Experience attacks more than four days per month or use painkillers on >10 days a month
• Need guidance on contraception or HRT because of aura‑related stroke risk
• Have migraine plus high blood pressure, diabetes or smoking history

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How We Diagnose and Monitor Migraine With Aura

1. Consultant Neurology Assessment – full symptom timeline, trigger review and neurological examination in our Neurology Service (/departments/neurology/).
2. Targeted Blood Tests – glucose, lipids, thyroid and vitamin levels via our Blood‑Testing Service (/diagnostics/blood-tests/).
3. Imaging When Indicated – CT in our on‑site CT Suite (/diagnostics/ct-scanning/) or MRI at our sister site for atypical aura, late‑onset symptoms or stroke mimics.
4. Headache Diary & Digital Tools – we provide templates/apps to track triggers and response to treatment.
5. Regular Follow‑Ups – reviews every 3–6 months to refine prevention and ensure stroke‑risk factors are controlled.

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Treatment and Prevention Options

Acute Relief

• Triptans (e.g., sumatriptan) taken early in the attack
• NSAIDs or paracetamol used judiciously to avoid rebound
• Anti‑emetics for nausea and vomiting

Preventive Medication (if ≥4 migraine days/month or disabling attacks)

• Beta‑blockers, topiramate or amitriptyline
• CGRP monoclonal antibodies (monthly injections) for difficult cases
• Magnesium, riboflavin and CoQ10 supplements where appropriate

Lifestyle and Stroke‑Risk Reduction

• Smoking cessation, blood‑pressure and cholesterol control with our Cardiology Department (/departments/cardiology/)
• Review of contraception/HRT—progestogen‑only or non‑hormonal methods are usually safer with aura
• Mediterranean‑style diet and weight management with the Dietetic Team (/departments/nutrition/)
• Sleep‑hygiene coaching and graded exercise through the Rehabilitation Service (/rehabilitation/stroke-rehab/)

Non‑Drug Therapies

• Vestibular and cervical physiotherapy if dizziness or neck pain triggers attacks
• Mindfulness‑based stress reduction, CBT or biofeedback to calm the stress response
• Neuromodulation devices (single‑pulse TMS or vagus‑nerve stimulators) discussed for refractory cases

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Why Choose The Royal Buckinghamshire Hospital?

• Consultant‑delivered clinics with appointments usually within one week
• Fast access to bloods, CT imaging and cardiometabolic screening on site
• Integrated pathway linking neurology, cardiology, dietetics and rehabilitation
• Flexible evening and Saturday clinics plus virtual follow‑ups
• Private ensuite rooms, free parking and easy links from Oxford, Milton Keynes and London

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Frequently Asked Questions

Is Migraine With Aura a Mini‑Stroke?
No. Symptoms are caused by reversible brain‑wave and blood‑flow changes, not permanent damage—but aura does signal a higher stroke risk, so prevention is key.

Can I Take the Combined Pill?
Generally not recommended with aura due to stroke risk. We’ll discuss safer alternatives.

Will Migraine Go Away With Age?
Attacks often lessen after menopause or later life, but good habits and preventive care help long before that.

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Take Control of Migraine and Protect Your Brain

Call 01296 678 800 or enquire online to book your migraine‑with‑aura assessment and personalised prevention plan.