On this page
Dr. Chrysoula I. Liakou MD, PhD
- Treated online: Yes, usually. Migraine with aura is diagnosed from your description and treated by video; a first aura, an aura in one eye only or weakness on one side needs urgent in-person care.
- What an aura is: temporary visual, sensory or speech symptoms, most often zigzag lines or flashing lights, that build over 5 minutes or more and last 5 to 60 minutes, usually before the headache.
- How common: up to a third of people with migraine have attacks with aura, and over 90% of them have visual aura at least some of the time.
- Stroke risk: migraine with aura about doubles the risk of an ischaemic stroke, so combined hormonal contraception is not routinely recommended, and stopping smoking matters.
- Emergency: call 112 for sudden loss of vision, weakness or numbness on one side, difficulty speaking, confusion, a seizure, or a sudden, extremely painful headache.
Do not book a video appointment if you have sudden loss of vision, weakness or numbness on one side of the body or face, difficulty speaking, confusion, a seizure or a sudden, extremely painful headache, especially if this has never happened before. These can be a stroke. Call 112 or go to an emergency department.
Can an online doctor treat migraine with aura?
Yes. Migraine with aura is diagnosed from your description of the attacks, which a doctor can take by video, and treated much like other migraine: treatment for the attack, and prevention when attacks are frequent. The doctor also checks your contraception and your stroke risk factors. A first aura, an aura in one eye only, weakness on one side, an aura lasting more than an hour, or one that does not fit the usual pattern needs urgent in-person assessment.
How an online consultation helps with migraine with aura
- Aura or something else?: The way the symptoms build, move and fade tells a typical aura from a mini-stroke or an eye problem.
- Treatment timed right: Painkillers and triptans work best taken as the headache starts, not during the aura.
- Contraception checked: Combined hormonal contraception is not routinely recommended with aura, and the doctor goes through the alternatives.
- Fewer attacks: Prevention when attacks are frequent, and help with smoking and other stroke risk factors.
What the doctor checks in an online migraine with aura consultation
The doctor asks about the warning signs first, then about the aura itself. The doctor asks about:
- Warning signs: sudden loss of vision, weakness or numbness on one side, difficulty speaking, confusion, or a sudden, extremely painful headache.
- The aura: what you see or feel, whether it spreads gradually, how long it lasts, and whether it affects one eye or both.
- The headache: whether it follows the aura, and how bad it is.
- Your history: when your auras started, whether they have changed, and your age.
- Stroke risk factors: smoking, blood pressure, and combined hormonal contraception such as the pill, patch or ring.
- Your family: relatives with migraine, or with weakness on one side during migraine.
Before the call, note what each aura looked like, how long it lasted and when the headache started. If you can, write the timings down as an aura happens: an aura diary helps the doctor.
What is a migraine aura, and what does it look like?
An aura is a set of temporary, fully reversible symptoms from the brain that usually come before, and sometimes during or after, the headache of a migraine. Visual aura is the most common type. You may see:
- zigzag lines that slowly spread across your vision
- flashing, flickering or shimmering lights
- a blind spot, or blurred vision
- coloured spots or lines
Other auras cause pins and needles that spread and turn to numbness, usually on one side, or difficulty speaking. A typical aura builds up over about 5 minutes, lasts 5 to 60 minutes, and is followed within an hour by a headache, though the headache does not always come.
How common is migraine with aura?
About 10 million people in the UK have migraine, and up to a third of people with migraine have attacks with aura. Many also have attacks without aura. Visual aura happens in over 90% of people who have auras, at least in some attacks.
What causes a migraine aura?
The leading explanation is cortical spreading depression: a slow wave of altered activity that moves across the surface of the brain and briefly changes its chemistry, nerves and blood flow, usually starting at the back, where vision is processed.
What can trigger an aura?
The usual migraine triggers: stress and tiredness, skipping meals, too much caffeine, alcohol, dehydration, smoking, low blood sugar, periods, and some types of hormonal contraception. A migraine diary helps find yours.
Ocular, retinal and visual migraine: what is the difference?
‘Ocular migraine’ is a confusing term that headache specialists no longer use. People use it for two different things: a visual aura, which affects both eyes, and retinal migraine, which affects one eye. The difference matters:
Swipe sideways to compare →
| Type | What happens | How long | How common |
|---|---|---|---|
| Visual aura (often called ocular or visual migraine) | Zigzags, flashing lights or a blind spot in both eyes | 5 to 60 minutes, usually before the headache | The most common aura |
| Retinal migraine | Temporary vision loss or a blind spot in one eye only | Usually 5 to 20 minutes, up to an hour | Rare |
| Aura without headache (silent migraine) | A typical aura with no headache afterwards | 5 to 60 minutes | More common in older people |
| Migraine with brainstem aura | Slurred speech, vertigo, ringing in the ears, double vision or unsteadiness | Usually under an hour | Rare |
| Hemiplegic migraine | Temporary weakness on one side of the body, with other aura symptoms | Usually under 24 hours, sometimes days | Rare |
Are ocular migraines mini-strokes?
No. A typical visual aura in both eyes is a migraine symptom, not a stroke. But vision changes in one eye are usually not caused by retinal migraine, and they can be a sign of a more serious problem that needs prompt treatment, so they need urgent assessment.
Is migraine aura dangerous? Stroke risk and contraception
A typical aura is temporary and fully reversible. Over the long term, migraine with aura is linked with a higher risk of ischaemic stroke, the type caused by a blocked blood vessel. In a 2009 analysis of studies, migraine with aura about doubled the risk, while migraine without aura did not raise it significantly:
Swipe sideways to compare →
| Group | Risk compared with people without migraine |
|---|---|
| Migraine with aura | About 2 times |
| Migraine without aura | Not significantly raised |
| Women with migraine under 45 | About 3.7 times |
| People with migraine who smoke | About 9 times |
| Women with migraine taking oral contraceptives | About 7 times |
These are relative risks: they show how much the risk rises, not how likely a stroke is. The higher risks with smoking and the contraceptive pill are why doctors advise people with aura to stop smoking, and why NICE advises against routinely offering combined hormonal contraception, such as the pill, patch or ring, to women with migraine with aura. Ask the doctor about contraception without oestrogen: the hormone headache page covers contraception and migraine.
What is hemiplegic migraine?
Hemiplegic migraine is a rare type of migraine with aura that causes temporary weakness on one side of the body, together with visual, sensory or speech symptoms. The weakness usually goes within 24 hours but can last days, and the headache can come before, after, or not at all. Because it looks like a stroke, a first attack must be treated as a stroke: call 112.
- Familial hemiplegic migraine runs in families: on average, half of the children of an affected parent develop it.
- Sporadic hemiplegic migraine has the same symptoms without a family history.
It is diagnosed and managed by specialists. Triptans are best avoided during the aura of hemiplegic migraine, and a specialist decides whether they are safe in the headache phase.
What are the red flags for an aura?
Most auras follow the same pattern each time. These features do not fit a typical aura and need checking:
Swipe sideways to compare →
| What you notice | What to do |
|---|---|
| Sudden loss of vision, or weakness, numbness or difficulty speaking that starts suddenly | Call 112 |
| Weakness on one side during an aura for the first time | Call 112 |
| Vision changes in one eye only | Get medical advice urgently, in person |
| Visual disturbances for the first time | Get medical advice urgently |
| An aura lasting more than an hour, or less than 5 minutes | Get medical advice urgently |
| A first aura, or aura without headache for the first time, after the age of 50 | Get medical advice urgently |
| Double vision, poor balance or reduced consciousness with an aura | Get medical advice urgently, in person |
| Auras that are changing, or coming more often | Book a consultation |
A typical aura builds gradually over 5 minutes or more, moves from one symptom to the next, and has ‘positive’ symptoms such as flashing lights or pins and needles. These features are what doctors use to tell aura from a mini-stroke.
Which migraine with aura treatment might the doctor recommend?
Treatment depends on how often attacks come, your other health conditions and your contraception. This is the framework the doctors use, in line with NICE guidance:
Swipe sideways to compare →
| What you have | Likely first step | Suitable for online care? | When in-person care is needed |
|---|---|---|---|
| Typical auras followed by a headache | A painkiller or a triptan with an anti-inflammatory, taken as the headache starts | Yes | If the pattern changes |
| Aura without headache, with a known pattern | Reassurance and a plan; acute treatment does not help the aura | Yes | If it is new, especially after 50 |
| Frequent attacks | Prevention, such as propranolol, topiramate or amitriptyline | Yes | If prevention does not work: a specialist |
| Migraine with aura on combined hormonal contraception | A switch to a method without oestrogen | Yes | For a coil or implant fitting |
| Vision loss in one eye | Urgent eye and medical assessment | No | Urgently, in person |
| Weakness on one side, or a first aura with speech problems | Emergency assessment | No | Call 112 now |
Not sure whether your flashing lights are an aura? A doctor can tell you in one consultation whether it fits migraine and what to do.
See available times →Treatment options for migraine with aura
How do you stop an aura?
There is no treatment that stops the aura itself. Most auras pass within an hour. Stop what you are doing, especially driving, rest somewhere quiet and dark, and take your migraine treatment as the headache starts. If you get auras without headache, attack treatments do not help, so talk to a doctor.
What you can do yourself
- Keep a diary of your attacks and possible triggers.
- Eat regular meals, drink enough water, and limit caffeine and alcohol.
- Sleep regularly, exercise, and find ways to manage stress.
- Stop smoking: it adds most to the stroke risk of migraine with aura.
- Use painkillers on no more than 2 days a week, to avoid medication overuse headache.
Prescription treatment
A prescription is never issued without a consultation. For the headache, the doctor may prescribe a triptan with an anti-inflammatory painkiller or paracetamol, and an anti-sickness medicine, taken as the headache starts. For frequent attacks, the doctor may suggest prevention with propranolol, amitriptyline or topiramate, and reviews the need for it after 6 months. Topiramate must not be used in pregnancy and needs highly effective contraception. Riboflavin (vitamin B2) may help some people. The doctor also reviews your contraception: combined hormonal methods are not routinely offered with aura. Opioids, including codeine, are not recommended for migraine and are never prescribed online. If the doctor prescribes, use the prescription at a pharmacy near you.
What does not help
Taking triptans or painkillers during the aura instead of at the start of the headache. Codeine and other opioids. Painkillers on most days. Driving while an aura is affecting your vision.
Special situations
Pregnancy
Paracetamol is the first choice for a migraine attack in pregnancy, and a triptan or an anti-inflammatory painkiller is considered only after discussing the risks. Prevention needs specialist advice, and topiramate must not be used. A new or severe headache in pregnancy needs urgent checks.
Over 50
Auras or headaches that start after 50, or a first aura without headache, need checking for other causes before they are labelled migraine.
Driving
A visual aura can make reading and driving unsafe. If one starts while you are driving, pull over safely and wait until it has completely passed.
Migraine with aura while travelling in Europe
Travel brings irregular meals, poor sleep, alcohol and dehydration. Carry your migraine treatment in your hand luggage and know its ingredient name. Sudden loss of vision or weakness abroad means 112.
Children
Mobi Doctor consultations are for adults aged 18 and over. A child who is unwell needs a paediatrician or a local doctor in person, and emergency signs in a child mean 112.
When migraine with aura is treated online, and when you need in-person care
Treated online: typical aura with a clear history, acute treatment, prevention, contraception reviews, help with stopping smoking, and aura without headache that has been checked before.
In-person care: a first aura, especially after 50, vision loss in one eye, weakness on one side or hemiplegic migraine, an aura lasting more than an hour, any atypical aura, and any emergency sign.
When to get in-person care
Call 112 or go to an emergency department now for:
- sudden loss of vision, or blurred or double vision
- sudden weakness or numbness in the face, an arm or a leg, especially on one side
- sudden difficulty speaking or remembering things, drowsiness or confusion
- a sudden, extremely painful headache that reaches its worst within 5 minutes
- a seizure
- a headache with a very high temperature and a stiff neck, or a rash that does not fade when a glass is rolled over it
- a headache after a head injury
Get medical advice the same day for:
- vision problems such as a blind spot, flashing lights or zigzags for the first time
- vision changes in one eye only
- an aura lasting more than an hour
- a migraine attack lasting more than 72 hours
- a migraine in pregnancy or soon after having a baby
How Mobi Doctor works
- Book a time that suits you: daily 7am–11pm CEST. You can see a doctor over video, usually within 15 minutes. No subscription, and the exact price is shown before you pay.
- Speak to a licensed doctor about your auras: describe what you see or feel, whether it affects one eye or both, how long it lasts and when the headache starts, and mention your contraception.
- Leave with a plan: what to do, what to take and for how long, and which signs mean you should be seen in person. If the doctor prescribes, use the prescription at a pharmacy near you.
No sign-up needed
Not sure it’s migraine with aura? Tick every symptom you have to see each condition page that mentions it. It finds the right page, not a diagnosis: a doctor gives you that on a video call. If you have an emergency sign listed on this page, call 112 instead.
Tap the body — an area or a point — to browse symptoms anywhere
Similar symptoms, different condition? Migraine can start the same way. Compare them, or look up any other symptom in the full symptom checker.
Frequently asked questions about migraine with aura
What is a migraine aura?
Temporary symptoms from the brain that usually come before the headache of a migraine. Most often they are visual, such as zigzag lines or flashing lights, but they can also be pins and needles, numbness or difficulty speaking. They build over about 5 minutes and last up to an hour.
What causes migraine with aura?
Migraine with aura is caused by a slow wave of altered electrical activity spreading across the surface of the brain, called cortical spreading depression, which produces the zigzags, numbness or speech symptoms as it passes and then sets off the pain pathways; the tendency is largely inherited, and attacks are triggered by missed meals, poor sleep, stress and the relaxation after it, hormonal changes around periods, alcohol, dehydration, bright or flickering light and some foods, usually in combination.
What does a migraine aura look like?
A migraine aura looks like zigzag lines spreading from the centre of your vision, flashing or shimmering lights, coloured spots or lines, a blind spot or blurred vision, usually in both eyes. It fades within an hour.
What is an ocular migraine?
A loose term that specialists no longer use. People use it for a visual aura, which affects both eyes, or for retinal migraine, a rare type that causes temporary vision loss in one eye. Vision loss in one eye always needs urgent checks.
Are ocular migraines mini-strokes?
No, a typical aura is a migraine symptom. But vision changes in one eye are usually not retinal migraine and can be a sign of a more serious problem, and sudden weakness or difficulty speaking needs 112.
What can trigger ocular migraines?
Stress, caffeine, alcohol, dehydration, smoking, high blood pressure, bending over, low blood sugar and some types of hormonal contraception can trigger retinal migraine, and the usual migraine triggers, such as missed meals and poor sleep, set off auras.
How can I prevent migraine with aura?
Keep regular meals, sleep and caffeine, drink enough, limit alcohol, manage stress and exercise regularly, and track triggers with a diary; women with migraine with aura avoid oestrogen-containing contraception and treat attacks around periods with a plan agreed with the doctor. If attacks come more than 4 days a month or are disabling, a daily preventive medicine, such as a beta-blocker, candesartan, topiramate, amitriptyline or a newer CGRP treatment, cuts their number, and not smoking also lowers the stroke risk.
How do you stop an ocular migraine?
No treatment stops an aura, and most pass within an hour. Stop what you are doing, rest somewhere quiet and dark, and take your migraine treatment as the headache starts. Frequent attacks can be prevented with daily medicine.
What can I do at home when a migraine aura starts?
At the first zigzags, stop what you are doing, especially driving, take your usual migraine painkiller or triptan as the doctor has advised, with an anti-sickness tablet if you use one, drink water, eat something if you have missed a meal, and lie down in a dark, quiet room; many people find the attack is milder when treatment goes in during the aura rather than after the headache starts. Note the time, the symptoms and the trigger in a diary for the doctor.
What are the red flags for ocular migraines?
Vision changes in one eye only, visual changes for the first time, an aura lasting less than 5 minutes or more than an hour, a first aura after 50, and weakness or speech problems. Sudden vision loss or weakness means 112.
Is migraine with aura dangerous?
The aura itself is temporary and fully reversible. Migraine with aura about doubles the risk of ischaemic stroke, and the risk is higher with smoking and the combined pill, so doctors advise stopping smoking and avoiding combined hormonal contraception.
Can you have an aura without a headache?
Yes. This is sometimes called silent migraine, and it is more common in older people. A first aura without headache, especially after 50, needs checking for other causes.
How long does migraine with aura last, and what is the outlook?
A migraine aura lasts 5 to 60 minutes and the headache that follows 4 to 72 hours, with tiredness for a day afterwards; attacks typically come a few times a year to a few times a month, and the aura pattern is usually the same each time. Migraine with aura often eases with age, particularly after the menopause, and apart from the small extra stroke risk, which is managed by not smoking and avoiding oestrogen, it does no lasting harm to the brain.
Can I take the combined pill if I have migraine with aura?
Combined hormonal contraception, such as the pill, patch or ring, is not routinely recommended with aura because of the raised stroke risk. Ask a doctor about contraception without oestrogen instead.
What is hemiplegic migraine?
A rare type of migraine with aura that causes temporary weakness on one side of the body. It usually settles within 24 hours. Because it looks like a stroke, a first attack must be treated as an emergency: call 112.
Can an online doctor treat migraine with aura?
Yes, usually. A doctor can diagnose it from your description by video, prescribe treatment and prevention, and review your contraception. A first aura, vision loss in one eye or weakness on one side needs urgent in-person care.
- Migraine, NHS, National Health Service (UK), reviewed 10 March 2026.
- Retinal (ocular) migraine, NHS, National Health Service (UK), reviewed 11 August 2026.
- Headaches in over 12s: diagnosis and management (CG150), NICE, National Institute for Health and Care Excellence, 2012, updated 2021.
- 1.2 Migraine with aura, International Classification of Headache Disorders, 3rd edition (ICHD-3), International Headache Society, 2018.
- 1.2.3 Hemiplegic migraine, International Classification of Headache Disorders, 3rd edition (ICHD-3), International Headache Society, 2018.
- Ocular migraine: when to seek help, Mayo Clinic (US), updated 1 August 2024.
- Migraine and cardiovascular disease: systematic review and meta-analysis, Schürks M, Rist PM, Bigal ME, Buring JE, Lipton RB, Kurth T. BMJ, 2009.
- Migraine with aura, The Migraine Trust (UK charity), updated September 2026.
- Hemiplegic migraine, The Migraine Trust (UK charity), updated 4 June 2026.
- Topiramate: referral (pregnancy prevention programme), EMA, European Medicines Agency, updated 23 November 2023.
- Headaches, NHS, National Health Service (UK), reviewed 17 April 2024.
- Combined pill: who can take it, NHS, National Health Service (UK), reviewed 15 February 2024.
This page is for information only and is not a substitute for a medical consultation. Guideline links are provided for transparency; treatment decisions are made with your doctor.
Related conditions
Related reading from the Mobi Doctor blog
How To Differentiate Migrains From Other Headaches
Migraines are often confused with tension, sinus, or cluster headaches. The key differences include pain type (throbbing...
Read article → Health and WellbeingMigraines And Birth Control
Can You Use Birth Control If You Have Migraines? Birth control and migraines affect each other depending on the migrain...
Read article → Diet & Nutrition8 Foods And Drinks That May Cause Migraine Symptoms
Which foods and drinks can trigger migraine symptoms? Certain foods and drinks may trigger migraine symptoms in sensiti...
Read article →Speak to a doctor about migraine with aura over video, usually within 15 minutes
Licensed doctors · open daily 7am–11pm CEST · exact price before payment
See available times →