There are a number of rare manifestations of migraines, and persistent migraine aura without infarction (PMA) is one of them. In a persistent aura without infarction, your aura doesn’t go away, even after the onset of themigraine headache.The most important feature of persistent migraine aura without infarction is themigraine auraitself. An aura is a reversible neurological disturbance that may precede or accompany a migraine headache. Typical auras last between five and 60 minutes, but in PMA, your aura can persist for a week or more.Also, the persistent aura is not due to any problems with the brain, so acomputerized tomography (CT)ormagnetic resonance imaging (MRI)of the brain will show no evidence of stroke as it would in another migraine complication, calledmigrainous infarction(migraine-related stroke).Verywell / Emily RobertsSymptomsMany people experience visual disturbances during an aura. These symptoms are the same in persistent migraine aura without infarction, only they last longer.Visual changes can include:Seeing zigzag linesSeeing flashing lightsVisual hallucinationsTemporary blind spots (scotomas)Blurred visionEven though most auras involve vision problems, neurological symptoms are possible as well, including a tingling sensation or numbness in a limb or on one side of the face, and/or speech and language difficulties.Other symptoms that may signal the onset of a migraine of any type are calledpremonitory symptoms. They usually begin hours to days before the pain begins and should not be confused with an aura. Premonitory symptoms include:Loss of appetite or food cravingChange in activity (more or less active)Low moodFrequent yawningPainNeck stiffnessFatigueCausesThe cause of migraines with aura and of PMA is unknown, though the aura may be owed to a type of electrical disturbance in the brain that creates the visual changes. The triggers are similar to that of migraines without aura: stress, hormonal changes, certain foods, bright light, and not getting enough sleep.DiagnosisTo confirm the diagnosis of persistent migraine aura without infarction, you must have visual symptoms consistent with migraine with aura that last one week or longer and no evidence of a stroke on a CT scan or MRI.As such, your healthcare provider will review your symptom history and conduct one or both of these imaging tests to reach this diagnosis. Keeping adiary of your symptomscan help paint a picture of what you’re experiencing for your practitioner.Causes and Risk Factors of HeadachesTreatmentIn most cases, typical migraine medications, such astriptansand ergot alkaloids, are not effective for treating persistent migraine aura without infarction. There are some reports that treating PMA with Diamox (acetazolamide) or Depakote (valproic acid) may be helpful. A 2014 study inHeadachefound that the anti-seizure medication Lamictal (lamotrigine) may be the most effective medication for treating PMA.Newer treatments to prevent migraines with and without auras, such as anti-CGRP (calcitonin gene-related peptide) medications likeZavzpret (zavegepant), may be beneficial.A Word From VerywellIf you have a migraine aura that lasts longer than an hour, be sure to contact your healthcare provider so you can be evaluated. He or she will want to rule out other more serious medical issues, like a stroke or an injured retina, before determining that you have persistent migraine aura without infarction.What Is Visual Snow Syndrome?
There are a number of rare manifestations of migraines, and persistent migraine aura without infarction (PMA) is one of them. In a persistent aura without infarction, your aura doesn’t go away, even after the onset of themigraine headache.
The most important feature of persistent migraine aura without infarction is themigraine auraitself. An aura is a reversible neurological disturbance that may precede or accompany a migraine headache. Typical auras last between five and 60 minutes, but in PMA, your aura can persist for a week or more.
Also, the persistent aura is not due to any problems with the brain, so acomputerized tomography (CT)ormagnetic resonance imaging (MRI)of the brain will show no evidence of stroke as it would in another migraine complication, calledmigrainous infarction(migraine-related stroke).
Verywell / Emily Roberts
Symptoms
Many people experience visual disturbances during an aura. These symptoms are the same in persistent migraine aura without infarction, only they last longer.Visual changes can include:
Even though most auras involve vision problems, neurological symptoms are possible as well, including a tingling sensation or numbness in a limb or on one side of the face, and/or speech and language difficulties.
Other symptoms that may signal the onset of a migraine of any type are calledpremonitory symptoms. They usually begin hours to days before the pain begins and should not be confused with an aura. Premonitory symptoms include:
Causes
The cause of migraines with aura and of PMA is unknown, though the aura may be owed to a type of electrical disturbance in the brain that creates the visual changes. The triggers are similar to that of migraines without aura: stress, hormonal changes, certain foods, bright light, and not getting enough sleep.
Diagnosis
To confirm the diagnosis of persistent migraine aura without infarction, you must have visual symptoms consistent with migraine with aura that last one week or longer and no evidence of a stroke on a CT scan or MRI.
As such, your healthcare provider will review your symptom history and conduct one or both of these imaging tests to reach this diagnosis. Keeping adiary of your symptomscan help paint a picture of what you’re experiencing for your practitioner.
Causes and Risk Factors of Headaches
Treatment
In most cases, typical migraine medications, such astriptansand ergot alkaloids, are not effective for treating persistent migraine aura without infarction. There are some reports that treating PMA with Diamox (acetazolamide) or Depakote (valproic acid) may be helpful. A 2014 study inHeadachefound that the anti-seizure medication Lamictal (lamotrigine) may be the most effective medication for treating PMA.
Newer treatments to prevent migraines with and without auras, such as anti-CGRP (calcitonin gene-related peptide) medications likeZavzpret (zavegepant), may be beneficial.
A Word From Verywell
If you have a migraine aura that lasts longer than an hour, be sure to contact your healthcare provider so you can be evaluated. He or she will want to rule out other more serious medical issues, like a stroke or an injured retina, before determining that you have persistent migraine aura without infarction.
What Is Visual Snow Syndrome?
4 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Headache Classification Subcommittee of The International Headache SocietyThe International Classification of Headache Disorders, second editionCephalalgia,24 (suppl. 1) (2004), pp. 9-160de Almeida RF, Leão IA, Gomes JB, da Silva AA Jr, Teixeira AL.Migraine with persistent visual aura: response to furosemide.Clinics (Sao Paulo). 2009;64(4):375–376. doi:10.1590/s1807-59322009000400019Brigham and Women’s Hospital.Visual migraine,Thissen S, Vos IG, Schreuder TH, Schreurs WM, Postma LA, Koehler PJ.Persistent migraine aura: new cases, a literature review, and ideas about pathophysiology.Headache.2014 Sep;54(8):1290-309. doi: 10.1111/headAdditional ReadingHeadache Classification Committee of the International Headache Society.The International Classification of Headache Disorders: 3rd Edition. https://www.ichd-3.org/1-migraine/1-4-complications-of-migraine/1-4-2-persistent-aura-without-infarction-2/
4 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Headache Classification Subcommittee of The International Headache SocietyThe International Classification of Headache Disorders, second editionCephalalgia,24 (suppl. 1) (2004), pp. 9-160de Almeida RF, Leão IA, Gomes JB, da Silva AA Jr, Teixeira AL.Migraine with persistent visual aura: response to furosemide.Clinics (Sao Paulo). 2009;64(4):375–376. doi:10.1590/s1807-59322009000400019Brigham and Women’s Hospital.Visual migraine,Thissen S, Vos IG, Schreuder TH, Schreurs WM, Postma LA, Koehler PJ.Persistent migraine aura: new cases, a literature review, and ideas about pathophysiology.Headache.2014 Sep;54(8):1290-309. doi: 10.1111/headAdditional ReadingHeadache Classification Committee of the International Headache Society.The International Classification of Headache Disorders: 3rd Edition. https://www.ichd-3.org/1-migraine/1-4-complications-of-migraine/1-4-2-persistent-aura-without-infarction-2/
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Headache Classification Subcommittee of The International Headache SocietyThe International Classification of Headache Disorders, second editionCephalalgia,24 (suppl. 1) (2004), pp. 9-160de Almeida RF, Leão IA, Gomes JB, da Silva AA Jr, Teixeira AL.Migraine with persistent visual aura: response to furosemide.Clinics (Sao Paulo). 2009;64(4):375–376. doi:10.1590/s1807-59322009000400019Brigham and Women’s Hospital.Visual migraine,Thissen S, Vos IG, Schreuder TH, Schreurs WM, Postma LA, Koehler PJ.Persistent migraine aura: new cases, a literature review, and ideas about pathophysiology.Headache.2014 Sep;54(8):1290-309. doi: 10.1111/head
Headache Classification Subcommittee of The International Headache Society
The International Classification of Headache Disorders, second edition
Cephalalgia,24 (suppl. 1) (2004), pp. 9-160
de Almeida RF, Leão IA, Gomes JB, da Silva AA Jr, Teixeira AL.Migraine with persistent visual aura: response to furosemide.Clinics (Sao Paulo). 2009;64(4):375–376. doi:10.1590/s1807-59322009000400019
Brigham and Women’s Hospital.Visual migraine,
Thissen S, Vos IG, Schreuder TH, Schreurs WM, Postma LA, Koehler PJ.Persistent migraine aura: new cases, a literature review, and ideas about pathophysiology.Headache.2014 Sep;54(8):1290-309. doi: 10.1111/head
Headache Classification Committee of the International Headache Society.The International Classification of Headache Disorders: 3rd Edition. https://www.ichd-3.org/1-migraine/1-4-complications-of-migraine/1-4-2-persistent-aura-without-infarction-2/
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