When people think of a migraine, what they are generally thinking about is a migraine with aura. But while the majority of migraine sufferers in fact never experience the aura phenomenon, at least fifteen to twenty percent of them do. There's a misconception that goes even further; that the aura consists only of visual phenomena. But with a classic migraine accompanied by the aura, the symptoms are more properly categorized as neurological, since they can manifest in other ways as well.
It's true that the effects most generally associated with the migraine with aura are related to vision. People might experience blind spots or see jagged light flashes or have an image split into shards. But for an hour or so prior to the severe headache coming onto the scene, the aura can produce other neurological effects as well, like tingling in the limbs or face, extra sensitivity to light or touch, and even slurring of speech. Since it's the nerves that are affected, and not the eyes directly, visual symptoms are just one kind of result of the extra nerve sensitivity.
Another type of migraine is sometimes mistaken for one with the aura, which is the ocular or ophthalmic migraine. This has similar visual symptoms to the standard aura, involving blind spots in the vision, as well as zigzagging or brightly flickering light. This type of migraine, though, might occur without a headache at all, as the phenomena originates in the blood vessels of the retina rather than in the occipital cortex, the area of the brain that processes vision (where the aura originates). So there is some debate about whether this is a migraine with aura at all, yet many doctors argue that the otherwise unexplained disturbances in the retinal blood vessels must also surely originate in the occipital cortex.
In the end, it doesn't matter that much where the aura symptoms come from. The fact is that whether a person experiences an ocular migraine without the headache or a migraine with aura that includes the headache, they will probably try doing the same things to prevent the migraine's arrival, and if or when it does come, they'll use the same treatment methods in both cases. The one thing the aura does is give the person who experiences it a little more advance warning of the approach of the headache. Yet this could be a very mixed blessing indeed.
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