Symptoms of the Migraine aura, the second potential phase of a Migraine attack, usually last from five to 60 minutes. Aura symptoms usually last from five to 60 minutes. Of course, each of us is different, so they could last longer.
It’s a different matter, however, when aura symptoms persist for a week or more, and we need to see our doctors if that occurs. If aura symptoms last this long, it could be a rare form of migraine aura called Persistent Aura without Infarction (an area of tissue death due to obstruction of the local circulation, aka stroke).
The International Headache Society’s International Classification of Headache Disorders, 3rd Edition (ICHD-3), is generally accepted as the “gold standard” for consistency in diagnosing and classifying head pain disorders, This provides standardization of diagnoses, providing guidance and reducing confusion.
The ICHD-3 on Persistent Aura Without Infarction:
1.4.2 Persistent aura without infarction
Aura symptoms persisting for 1 week or more without evidence of infarction on neuroimaging.
- Aura fulfilling criterion B
- Occurring in a patient with 1.2 Migraine with aura and typical of previous auras except that one or more aura symptoms persists for 1 week or longer
- Neuroimaging shows no evidence of infarction
- Not better accounted for by another ICHD-3 diagnosis.
Persistent aura symptoms are rare but well documented. They are often bilateral and may last for months or years. The 1-week minimum in criterion B is based on the opinion of experts and should be formally studied.
Diagnostic work-up must distinguish 1.4.2 Persistent aura without infarction from 1.4.3 Migrainous infarction, and exclude symptomatic aura as a result of cerebral infarction of other causes. Attacks lasting more than 1 hour and less than 1 week and not fulfilling criteria for 1.2.1 Migraine with typical aura are coded 1.5.2 Probable migraine with aura.
Implications for Migraine Patients:
Whenever we have new, strange, or frightening symptoms, we need to check in with our doctors. In the case of migraine aura symptoms that last longer than they should, this can be especially important. Many of these same symptoms can be symptoms of infarction or stroke, and it’s important to determine which is causing the symptoms. An imaging study may be necessary.
I have been diagnosed with Persistent migraine aura without cerebral infraction and without status migrainosus, not intractable. Also, I don’t experience the actual migraine just a mild temporary headache. It’s been six weeks and my right hand, right 1/2 face and tongue are totally numb constantly. I have had an MRI, untrasound for arteries and blood vessels, blood work up, etc. with all negative findings. Two years ago started with ocular migraines here and there. October 3rd started with tingling in hand, then face and within an hour two ocular migraines with bright light affecting central vision. How long could these symptoms last? Any thoughts would be greatly appreciated.
Hi Lori, I’ve also been experiencing this and after images. MRI, BP, and things of that nature are fine. I started getting migraines after violently throwing up bile due to my severe menstrual cramps. From there, visual symptoms, do you have any advice? The after images, dizziness, and eye pain control my life, it’s very depressing.
I’ve had persistant aura without headache everyday(not all day) for 17 months. Peripheral, bilateral & flashing. All tests check out ok but still have a checkup with a Retina Specialist to cover that also. But everyday for 17 months now . I do have headaches also every few days. Your article is the first time I’ve read that auras can last for years and that’s what my specialist has said.