Migraine with aura

Diagnosis

Based on your signs and symptoms, medical and family history, and a physical examination, your doctor may make the diagnosis of a migraine with aura.

Your doctor may advise some tests to rule out more serious illnesses, such as a transient ischemic attack (TIA), if your aura is not accompanied by head pain.

Assessments may consist of:

• Eye examination. A complete eye examination performed by an ophthalmologist, an expert in eyes, can help rule out eye issues that could be producing visual disturbances.
• Computerized Tomography (CT) scan. Your brain may be seen in great detail from this X-ray procedure.
• Magnetic Resonance Imaging (MRI). Your internal organs, including your brain, are depicted in images created during this diagnostic imaging technique.

To rule out any possible brain illnesses that could be the source of your symptoms, your doctor may recommend that you see a neurologist, a physician who specializes in nervous system disorders.

Treatment

Similar to migraine alone, treatment for migraine with aura focuses on reducing migraine pain.

Medications

When administered as soon as the warning signs and symptoms of a migraine aura appear, medications used to treat migraine discomfort function best. Types of drugs that can be used to treat migraines depend on how severe the pain is.

• Pain relievers. Aspirin or ibuprofen are among these over-the-counter or prescription painkillers. These may result in headaches from pharmaceutical overuse if taken too regularly, as well as ulcers and gastrointestinal bleeding.

Migraine drug that contains caffeine, aspirin, and acetaminophen may be effective, but often just for treating mild migraine pain.

• Triptans. Because they block the brain’s pain pathways, prescription medications including sumatriptan and rizatriptan are used to treat migraines. They can ease a number of migraine symptoms when taken as pills, injections, or nasal sprays. For people at risk of a heart attack or stroke, they might not be secure.
• Dihydroergotamine. For migraines that often last longer than 24 hours, this medication, which is available as a nasal spray or injection, is best effective when administered soon after the onset of migraine symptoms. The nausea and vomiting that come with migraines may get worse as a side effect.
  Avoid dihydroergotamine if you have kidney or liver disease, coronary artery disease, high blood pressure, or any of these conditions.
• Lasmiditan. This more recent oral tablet has been given the green light to treat migraines with or without aura. Lasmiditan dramatically reduced headache pain during pharmacological studies. People using lasmiditan are advised not to drive or handle machinery for at least eight hours since it can have a sedative effect and cause dizziness.
• Calcitonin gene-related peptide (CGRP) antagonists. Oral CGRP antagonists ubrogepant and rimegepant have just been licensed for the treatment of acute migraine in adults, either with or without aura. In clinical studies, medications in this family were superior to placebo in reducing migraine pain and other symptoms such nausea and sensitivity to light and sound two hours after administration.

The usual adverse effects include extreme sleepiness, nausea, and dry mouth. Strong CYP3A4 inhibitor medications shouldn’t be taken with ubrogepant or rimegepant.

• Opioid medications. Narcotic opioid drugs may be useful for migraine sufferers who are unable to take other migraine medications. These are often only used if no other therapies work because they can be quite addictive.
• Anti-nausea drugs. If your migraine with aura is accompanied by nausea and vomiting, these can be helpful. Chlorpromazine, metoclopramide, and prochlorperazine are all anti-nausea medications. These are typically used along with painkillers.

Some of these medicines should not be used while pregnant. Avoid using any of these medications if you are pregnant or trying to get pregnant without first consulting your doctor.