Persistent Migraine Aura Without Infarction

An Aura That Won't Go Away

Man with migraine
Migraines have several complications. PhotoAlto/Alix Minde/Getty Images

There are a number of rare complications of migraines, and persistent migraine aura without infarction (PMA) is one of them. In a persistent aura without infarction, your aura doesn't go away, even after you have a migraine, and may last for a week or longer. The symptoms look similar to that of someone having a stroke.

Major Feature of Persistent Aura Without Infarction

The most important feature of persistent aura without infarction is the migraine aura itself. An aura is a reversible neurological disturbance that's typically visual that may precede or accompany a migraine headache. Typical migraine auras last between five and 60 minutes, but in PMA, your aura can persist for a week or more. Also, the persistent aura is not due to any problems with the brain, so a computerized tomography (CT) or magnetic resonance imaging (MRI) of the brain will show no evidence of stroke as it would in another migraine complication, called migraine infarction (migraine stroke).

Symptoms of a Migraine Aura

Many people experience some change in their vision during an aura. Visual changes can include:

Even though many auras involve vision, you may experience other symptoms as well, like speech or sensory disturbances.

Other Symptoms That Signal a Migraine

Other symptoms that may signal the onset of a migraine are called premonitory symptoms. They usually begin hours to days before the pain begins and should not be confused with an aura, which is temporary and causes neurological symptoms.

Premonitory symptoms include:

  • Loss of appetite or food craving
  • Change in activity (more or less active)
  • Low mood
  • Yawning a lot
  • Pain
  • Neck stiffness
  • Fatigue

Treating Persistent Aura Without Infarction

Treatment for a migraine aura begins with treating the migraine itself. In most cases, routine abortive migraine treatments will work for your usual migraine with aura.

If the aura continues after the migraine, however, there is little that can be done. There are some reports that treating PMA with acetazolamide or valproic acid may be helpful. A study in Headache found that the anti-seizure medication Lamictal (lamotrigine) may be the most effective for treating PMA.

Causes of Persistent Aura Without Infarction

The cause of migraines with aura and of PMA is unknown, though the aura may be a type of electrical disturbance that creates the visual changes. The triggers are similar to that of migraines without aura: stress, hormonal changes, certain foods, bright light, and not getting enough sleep.

When to See Your Doctor

If you have a migraine aura that lasts longer than an hour, be sure to contact your healthcare provider so you can be evaluated. He or she will want to rule out other more serious medical issues, like a stroke or a retinal tear, before deciding that you have persistent aura without infarction.

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