Auras can be confused with sudden onset of panic or migraine headache

An aura is a perceptual disturbance experienced by some migraine sufferers before a migraine headache, and the telltale sensation experienced by some people with epilepsy before or after a seizure. It often manifests as the perception of a strange light, an unpleasant smell or confusing thoughts or experiences. Some people experience aura without a subsequent migraine or seizure (see silent migraine).

When occurring, auras allow people with epilepsy time to prevent injury to themselves and/or others. The time between the appearance of the aura and the migraine lasts from a few seconds up to an hour. The aura can stay with a migraine sufferer for the duration of the migraine; depending on the type of aura, this can leave the person disoriented and confused. It is not uncommon for migraine sufferers to experience more than one type of aura during the migraine. Most people who have auras have the same type of aura every time.

Auras can also be confused with sudden onset of panic, panic attacks or anxiety attacks creating difficulties in diagnosis. The differential diagnosis of patients who experience symptoms of paresthesias, derealization, dizziness, chest pain, tremors, and palpitations can be quite challenging.


An aura sensation can include some or a combination of the following:

Visual changes

  • Bright lights and blobs
  • Zigzag lines
  • Distortions in the size or shape of objects
  • Vibrating visual field
  • Scintillating scotoma
  • Shimmering, pulsating patches, often curved
  • Tunnel vision
  • Scotoma
  • Blind or dark spots in the field of vision
  • Curtain-like effect over one eye
  • Slowly spreading spots
  • Kaleidoscope effects on visual field
  • Temporary blindness in one or both eyes
  • Heightened sensitivity to light

Auditory changes

  • Hearing voices or sounds that do not exist: true auditory hallucinations
  • Modification of voices or sounds in the environment: buzzing, tremolo, amplitude modulation or other modulations
  • Heightened sensitivity to hearing
  • Someone speaking at a level and normal tone sounds like they are shouting loudly

Other sensations

  • Strange smells (Phantosmia) or tastes (Gustatory hallucinations)
  • Heightened sensitivity to smell
  • Déjà vu
  • Nausea
  • A sudden feeling of anxiety, fear or foreboding
  • Numbness or tingling sensation (Paresthesia)
  • Weakness on one side of the body (Hemiparesis)
  • Feelings of being separated from or floating above one’s body
  • Sensation of limbs or teeth growing
  • Feeling of overheating and sudden perspiration
  • Inability to speak (Aphasia) or slurred speech
  • Confusion; forgetting how to do common tasks or comprehend spoken words