Vision or speech changes that occur during a migraine can feel frightening. Many people worry that they are having a stroke or that something serious is going on. The reassuring news is that these symptoms can occur in certain types of migraines, especially migraines with aura, and they often have full recoveries. What is key is understanding what is typical for a migraine and what requires urgent medical attention.
Dr Bazo Raheem, Consultant Neurologist and Headache specialist, explains that a migraine is a neurological condition and not just a bad headache. He also notes that some people experience an “aura, which are temporary neurological symptoms that can occur before or during the headache — for example, flashing lights, zig-zag patterns in vision, tingling, or problems with speech.” Recognising these features can help patients feel safer and more informed.
Doctify can help you find qualified neurologists and headache specialists who can help you determine whether your headaches are migraines and provide you with tailored care for your needs.
What is a Migraine Aura?
A migraine aura is a temporary neurological symptom that appears before or during a migraine episode. It usually lasts between 20 minutes and an hour, and then improves. Aura happens because of brief changes in brain activity and blood flow. Not everyone with migraines experiences auras, but those who do can usually notice a clear pattern.
Common aura symptoms include changes in vision, speech, or sensation. While these symptoms can be unsettling, they are usually reversible and go away with time.
Vision changes caused by migraine aura
Visual aura is the most common type, and symptoms can include:
- Flashing ligts or zigzag lines
- Shimmering spots
- Blurred or distorted vision
- Blind spots or patches of missing vision
Although symptoms can feel like the only effect on one eye, the visual pathways of the brain are interconnected, which means that auras usually involve both eyes in some way. These changes often build gradually over several minutes and resolve within an hour.
Dr Raheem notes that aura symptoms are part of the regular migraine process and represent temporary changes in the nervous system.
Speech and language changes during migraine
Some people develop trouble speaking during the aura phase of a migraine. This may include difficulty finding words, slowed speech, or temporary confusion. When the areas of your brain that are responsible for language are affected, speech can become unclear and muddled. These symptoms typically improve once the aura phase ends.
Speech problems are recognised features of migraine aura that can look alarming, but they often fully resolve.
Other neurological symptoms that can occur
In the aura phase, some people may also experience a sensation of heaviness, feelings of confusion or fogginess in addition to tingling or numbness in the face, arm or hand.
These symptoms can look like symptoms from other conditions, which is why understanding your personal migraine pattern is important.
Migraine Aura vs Stroke: How they differ
Typical migraine features
You are most likely experiencing a migraine if your symptoms developed gradually rather than suddenly or if your symptoms spread from one area to another. Additionally, if your visual, speech, or sensory symptoms resolve completely within an hour, you are likely dealing with a migraine.
Stroke warning signs
Your symptoms are likely to be due to a stroke if they appear suddenly without progression or if you experience weakness on one side, a sudden loss of speech, or if there is facial droop. Another major sign that you are dealing with a stroke is if the symptoms persist without improvement.
New or sudden neurological symptoms should always be checked, even if you have a history of migraine.
When to seek urgent medical help
You should seek emergency care if you experience:
- Your first-ever migraine with neurological symptoms
- New or severe speech or vision problems
- Symptoms lasting longer than an hour
- Aura symptoms without a headache, especially if you are older than forty
- Any event that feels different from your usual migraine pattern
If you are in doubt, its is safer to get a formal assessment. Doctify can connect you with reviewed and verified Neurologists who can work with you and help get to the cause of your symptoms.
How neurologists assess these symptoms
Neurologists begin by going over your symptoms, timeline, and migraine history. They may perform a targeted neurological assessment and order imaging if they need to rule out stroke or other potential conditions. Diagnosis is often made without tests, but safety checks are an important part of care.
Dr Raheem emphasises the value of identifying migraine patterns, noting that it is “a condition that moves through several phases, rather than just being a headache”. These phases include pre-monitory signs, aura phase, the headache and the recovery symptom phase. This helps clinicians distinguish migraines from other neurological conditions.
Managing migraines with aura
Migraine with aura can often be managed with:
- Early treatment when the aura begins
- Prescribed migraine medications such as triptans or gepants
- Preventive treatment for frequent attacks
- Lifestyle management, including sleep regulation, adequate water intake, regular meals, and stress control
Certain triggers can increase the frequency of experiencing auras, including hormonal changes, disrupted sleep or dehydration.
Dr Raheem highlights the importance of treating early and avoiding the overuse of certain medications. He explains that taking too many painkillers can lead to overuse headaches, which makes migraines worse rather than better.
Living confidently with migraine aura
Understanding your personal migraine pattern can make aura symptoms feel less alarming and more predictable. Keeping a migraine diary helps track triggers, early signs and the way you respond to different treatments. It is also very important to know that aura does not typically cause permanent damage, and many people learn to manage their symptoms well with the right support.
Regular follow-up is important in the event that your symptoms change or affect you more often.
Final takeaway
Vision or speech changes during migraine can be part of the aura phase, but they should never be ignored if they are new or out of the ordinary. Knowing the main differences between migraine auras and emergency symptoms can help you stay safe and feel confident about your health. Neurologists can provide expert assessment, personalised treatment and reassurance.
Docitfy helps you find trusted neurologists like Dr Bazo Raheem for accurate diagnosis and tailored migraine management.
Find the right specialist for you. Doctify uses verified reviews so you can make the best decision for your healthcare.
Find the best neurologists in the United Kingdom, or search for trusted experts globally:
- Neurologists in Ireland
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Medically Reviewed
Last reviewed on 15/12/2025
