This guide is general information, not medical advice. Medicines and treatments must be prescribed or recommended for you by a doctor or pharmacist. We do not give doses here.
Related guides: Aura without headache, Migraine with brainstem aura, Hemiplegic migraine, Migraine, aura and stroke.
What it is
Aura is a set of temporary symptoms caused by a slow wave of changed activity spreading across the brain. It usually starts before the headache, but it can come during or after it, and some attacks have aura with no headache at all.
Estimates of how many people with migraine get aura vary: The Migraine Trust says up to a third, and the National Migraine Centre says around 20 to 25%. It used to be called classic migraine.
What aura feels like
Visual
Zigzag or shimmering lines, flashing or sparkling lights, blind spots or blurring. It usually affects sight in both eyes and spreads or changes shape.
Sensory
Pins and needles or numbness that spreads slowly, often from the hand up the arm to the face.
Speech
Difficulty finding words or speaking clearly.
Other
Dizziness or ringing in the ears. Weakness is uncommon and needs checking by a doctor.
Symptoms often follow one another, for example sight changes then tingling. Avoid driving or using machinery during an aura.
How long it lasts
Aura builds over about 5 minutes and usually lasts between 5 and 60 minutes, often 15 to 30. The headache, if it comes, usually follows within an hour and can last 4 to 72 hours.
Stroke risk and contraception
Migraine with aura is linked to a small rise in the risk of stroke. The extra risk is very small for most people, but it is higher if you smoke, have high blood pressure or cholesterol, or take oestrogen-containing contraception.
Because of this, the combined pill and other contraception containing oestrogen should not be used by women who get aura. Progestogen-only methods are suitable. If you get aura for the first time while on the combined pill, stop taking it, use another method such as condoms, and speak to a doctor the same day.
Keeping blood pressure, cholesterol and weight in check and not smoking all lower the risk.
Treatment
Treatments for attacks don't stop the aura itself. Take painkillers or a triptan when the headache begins, not during the aura, as triptans usually don't work if taken too early. If aura is frequent or disabling, ask your GP about preventive treatment.
During an attack
Simple painkillers
Pharmacy or supermarket
Aspirin, ibuprofen or paracetamol, taken as early as possible in the headache. Aspirin and ibuprofen usually work better than paracetamol for migraine.
Triptans
Prescription, and some from a pharmacist
Medicines made for migraine, as tablets, melts, nasal sprays or injections. If one doesn't suit you, another often will. They aren't suitable for people with heart or circulation disease.
Anti-sickness medicines
Prescription
They ease sickness and help your body take in other medicines during an attack.
Gepants
Specialist or GP, depending on your area
Newer tablets for people who haven't been helped by at least two triptans, or who can't take triptans and haven't been helped by simple painkillers.
Preventing attacks
Preventive tablets
Usually from your GP
Considered if you have 4 or more migraine days a month, or attacks badly affect your life. Options include beta-blockers such as propranolol, amitriptyline, topiramate and candesartan. They are started at a low dose and built up. Give each one at least 3 months at a good dose before deciding. Topiramate and sodium valproate can harm an unborn baby: they must not be used in pregnancy, and anyone who could become pregnant needs highly effective contraception while taking them.
CGRP medicines
Specialist, after GP referral
Monthly or 3-monthly injections, a hospital drip every 3 months, or daily or every-other-day gepant tablets, that block a chemical involved in migraine. On the NHS they are usually offered once at least 3 preventive tablets haven't worked.
Nerve blocks
Specialist clinic
An injection of local anaesthetic, sometimes with a steroid, at the back of the head. It can calm migraine for a few weeks to around 3 months.
Supplements and devices
Usually self-funded
Riboflavin (vitamin B2), magnesium and coenzyme Q10 help some people. Nerve stimulation devices such as Cefaly, gammaCore, Nerivio and sTMS can be bought privately but aren't on the NHS for migraine.
When to get urgent help
Aura can look like a stroke. If you're not sure, get help straight away.
Call 999 if you have
- a sudden, extremely bad headache that peaks within minutes
- weakness, numbness or a drooping face on one side, or slurred speech
- sudden loss of sight
- confusion, drowsiness or a seizure (fit)
- a high temperature with a stiff neck or a rash
- a headache after a head injury
Call NHS 111 if
- your aura lasts more than an hour
- you have aura for the first time
- your aura is different from usual
- you get aura for the first time while on the combined pill (stop taking it and get advice the same day)
- aura starts for the first time after the age of 50
See your GP if
- aura is getting more frequent
- you have aura and want to review your contraception
Work and your workspace
Migraine can count as a disability under the Equality Act 2010 (the Disability Discrimination Act in Northern Ireland) if it has a substantial, long-term effect on your everyday life. Conditions that come and go still count, and the law looks at how you would be without treatment. If it applies, your employer must make reasonable adjustments.
Adjustments that often help
- Being able to stop work and rest during an aura
- Not driving or using machinery during an aura
- Regular screen breaks and low-glare screens
- Flexible hours and working from home
- Time off for appointments
A migraine-friendly workspace
- A chair with good lumbar and neck support
- A desk big enough to put your screen at arm's length
- Screen raised so the top is at eye level
- A flicker-free monitor with an anti-glare or blue-light filter
- Lighting without flicker or glare, and blinds to control daylight
Access to Work can pay towards equipment and support. Acas and Citizens Advice give free advice on your rights.
How The Beyond Pain Foundation can help
If NHS waits are too long, or the help you need is not available to you on the NHS, we may be able to fund:
- A private headache specialist appointment to confirm the diagnosis and plan treatment
- A nerve stimulation device recommended by your doctor
- Screen filters, flicker-free monitors and lighting changes to cut visual triggers
- Support to stay in work, such as travel to specialist appointments
Every award depends on your situation and the funds we have that month. A letter from your doctor, a headache diary and a written quote all help your application.
Support and sources
The Migraine Trust
Information and support service
Information on every type of migraine, a free information and support service, and advice on treatment and work.
migrainetrust.orgNational Migraine Centre
Charity headache clinic
Specialist appointments in person and online, including routine appointments for a voluntary donation, plus free factsheets.
nationalmigrainecentre.org.ukNHS
Health information
Symptoms, treatment and when to get help with migraine and headache.
nhs.uk/conditions/migraineSources for this guide
Written in our own words from the sources above. Last reviewed: October 2026. Figures can differ between sources; where they do, we give the range.