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Medical Edge Newspaper Column from Mayo Clinic

FOUR TYPES OF ‘AURA’ MAY PRECEDE MIGRAINE HEADACHE

DEAR MAYO CLINIC: My father used to get headaches so bad he couldn’t even listen to the ballgame on the radio. For him, that was saying something. I’m 48 and healthy, and for the last few years I’ve been getting headaches. Then something happened that threw me for a loop: I had this crazy black-and-white zigzag hallucination along with the headache. I rushed to my eye doctor and he said it was part of the migraine deal, and it’s called an aura. What is an aura? — Philadelphia

ANSWER: About 15 percent of the people who have recurrent migraine headaches experience the “migraine aura.” This is a collection of sensory warning signs that gradually appear before the migraine starts and typically last 15 minutes to an hour.

People have different kinds of auras. The most common is the visual type that you describe. It usually begins in the side vision of both eyes, and appears as a zigzag or shimmering visual disturbance that’s either in color or black and white. After a while, the pattern fades, though it may leave a temporary blind spot.

The second most common type is a sensory aura. People who have them get a prickly or numb feeling on one side of the face, or in one of their hands, arms or legs. The tingling gradually disappears, but it may be replaced by numbness.

The third most common aura affects language. People who have a language aura may have symptoms that range from difficulty finding the right words to inability to express themselves. When experiencing a language aura, people use words incorrectly and sometimes speak in gibberish. That’s quite frightening to patients.

Finally, motor aura is the least common type. Patients have symptoms that range from clumsiness to paralysis on one side of the body. The symptoms typically last for a few minutes to hours, but in some patients, they can last for days.

— Jerry Swanson, M.D., editor, Mayo Clinic on Headache

Additional Resources:
Treatment of Migraine Headache
Appointment Information
More Information on Migraine Headaches

DEAR MAYO CLINIC: I’m 44 and healthy and try to keep up with the latest ways to stay healthy. I don’t smoke and I exercise regularly. But my father died of a stroke when he was 45, so lately I’ve been wondering about my risk for stroke. How do I get checked out for that? — Memphis, Tenn.

ANSWER: A stroke is a potentially life-threatening event that occurs when there is a lack of blood supply to the brain or when a brain artery bursts, causing blood to spill into the surrounding tissue.

Talk with your health-care provider during your routine annual exam about evaluating your risk for stroke. If you know any details about your father’s stroke, share them with your doctor. This knowledge may help your doctor determine if you’re at increased risk, and what can be done to lower that risk.

We can’t control some risk factors — advanced age or family history, for example — but we can influence others, such as elevated cholesterol, high blood pressure, type II diabetes and a sedentary lifestyle. Cigarette smoking is another risk factor, so it’s very good that you don’t smoke.

In addition, there are naturally occurring chemicals in the blood that might increase the risk of stroke if elevated. Your doctor can check the blood levels of these chemicals.

Several other tests may be done to assess your risk of stroke. Some are very simple. For example, your physician can place a stethoscope against the carotid artery in your neck and listen for a telltale sound called a “bruit” (BRU-ee). This is the sound made by turbulent blood flow. It can be an indicator that cholesterol-containing plaque is clogging your carotid artery.

If your doctor hears a bruit, he or she may want to do additional tests on your arteries, including a carotid ultrasound. This noninvasive test uses high frequency sound waves to view the carotid arteries and look for obstructions. Other tests using computed tomography (CT) and magnetic resonance imaging (MRI) might also be used to evaluate your arteries.

— Robert Brown, M.D., Neurology, Mayo Clinic, Rochester, Minn.

Additional Resources:
Treatment of Stroke
Appointment Information
More Information on Strokes
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Medical Edge from Mayo Clinic is an educational resource and doesn’t replace regular medical care. To e-mail a question, go to www.mayoclinic.org, or write: Medical Edge from Mayo Clinic, c/o TMS, 2225 Kenmore Ave., Suite 114, Buffalo, N.Y., 14207. For health information, visit www.mayoclinic.com.