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FLASHES, SHIMMERS AND BLIND SPOTS: HERE’S WHAT MIGRAINE AURA LOOKS LIKE

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This video illustration represents a common type of visual aura, characterized
by a blind spot bordered by shimmering light. (Brian Monroe/The Washington Post
and Alexa Juliana Ard/The Washington Post)
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By Alexa Juliana Ard and 
Brian Monroe
Dec. 21 at 6:00 a.m.

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Blurred vision. Shimmering lights. Blind spots. Zigzag lines. This is what
migraine aura looks like.

Migraine is a neurological disorder characterized by severe, even debilitating,
pain on one side of the head, and can be accompanied by other symptoms such as
aura, a sensory disturbance that can cause temporary visual impairment.

The Washington Post spoke to four chronic-migraine sufferers about living with
migraine aura. Based on their vivid descriptions, we created video illustrations
to show what migraine auras look like through the eyes of people who suffer from
them.

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BETHANY’S AURA

Bethany Noël, a 36-year-old professional artist from Boston, is one of the more
than 1 billion people worldwide who suffer from migraine, and among the
estimated 25 percent of migraine sufferers who experience aura. She sees it most
days, whether her eyes are open or closed.

Noël experiences aura in various ways, which she tries to capture in her art.
She describes one aura as resembling a heat wave that can include swirls of
color or darkness. She said that sometimes parts or even all of her vision goes
black or she sees “deep galaxy swirls of color,” like this.



Noël has suffered from chronic migraine with aura since she was 10 years old. It
took several doctors, medical tests and trips to the emergency room over more
than a decade before she was diagnosed in her early 20s.

Migraine is the second leading cause of disability in the world, and the first
among young women. Attacks can last for hours or days. It affects more than 12
percent of the U.S. adult population.

Scientists don’t fully understand the mechanisms of aura, but they have several
theories. In patients with migraine, researchers have seen a phenomenon called
cortical spreading depression, a wave of altered brain activity that may reduce
blood flow in the visual cortex, leading to visual disturbances. It may also be
related to hormonal changes. Migraine is three times more common in women,
especially in their reproductive years.

Bethany Noël hasn't had a day free of migraine pain since 2020. (Alexa Juliana
Ard/The Washington Post)

Noël said she paints to push back from the despair that comes from living with a
chronic illness. She has been selling her art since she was 15 years old.

“My paintings are a much more accurate depiction of the intensity of color that
I experience,” she said.

Visual aura is a symptom of chronic migraine. Bethany Noël, a professional
artist, paints the auras she sees as part of her experience living with chronic
migraine. (Bethany Noël) Bethany Noël says painting her aura helps her cope with
chronic migraine. (Bethany Noël)

Sometimes her aura includes shimmering lights or bright glares, like this.

How Bethany Noël sees migraine aura
3:11

Bethany Noël has suffered from chronic migraine with aura since she was 10 years
old. She paints the auras she sees to give others a glimpse into her world.
(Alexa Juliana Ard/The Washington Post)

During one migraine attack, Noël described the feeling as if someone was trying
to “poke a spear” out of her eye on the right side of her head. A trip to the
pharmacy to pick up her prescription medication can make an attack worse because
of her sensitivity to light, smell and sound. Her symptoms can also include
dizziness, nausea and aphasia, a disorder that makes it difficult to
communicate.



Her paintings depict the woods and the way her aura turns them into an
“exploration of Narnia.”

Noël's paintings often depict how her visual aura appears when she's in the
woods. (Alexa Juliana Ard/The Washington Post)
Noël uses chalk, pastel, graphite, gesso and acrylic paint to create
representations of her migraine aura. (Alexa Juliana Ard/The Washington Post)
Noël has sketches pinned to the walls of her studio. (Alexa Juliana Ard/The
Washington Post)

In 2021, she began a preventive treatment for chronic migraine called
eptinezumab, sold under the brand name Vyepti, which is given by intravenous
infusion every three months.

At Brigham and Women’s Hospital, where she receives the treatment, the bright
lighting can make her migraine worse. When she is called to begin the 30-minute
infusion, she asks for the lights to be turned off.

Pain-free days are rare for Noël, but an infusion treatment called Vyepti has
helped decrease the severity of her chronic migraine symptoms. (Alexa Juliana
Ard/The Washington Post)

After an infusion, Noël received her bill from Brigham and Women’s Hospital for
more than $21,000. Under her insurance with Blue Cross Blue Shield, her
out-of-pocket cost was $4,000.

An excerpt from Noël's migraine treatment.

Noël also takes Ubrelvy, a prescription medicine that can reduce the severity of
a migraine once it has started. The drug can cost about $100 per pill. Vyepti
and Ubrelvy are in a class of drugs that act on a protein in the brain called
CGRP or its receptor. CGRP stands for calcitonin gene-related peptide, and it’s
released during migraine. Drugs in this class work by blocking CGRP from
attaching and activating specific receptors believed to play a role in migraine.

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Some people who experience migraine say that some of the CGRP drugs help
initially but later stop being effective. That’s what happened to Noël after she
tried Emgality, a monthly self-injection. The drug was “significantly life
changing,” she said, but then it stopped working.



Even with the advancements in migraine treatment and their costly price tag,
Noël is still not symptom free.

She said her last day without pain was in 2020. Of all the treatments she’s
tried, she said the CGRP treatment has done the best at making her chronic
migraine symptoms less severe and more manageable.

On a scale of one to 10, “If my average pain level for the month is under a
five, that’s a pretty good success for me,” she said.


KEISHA’S AURA

After a car accident in 2014, Keisha Patterson noticed a change in her vision.
She thought she just needed new glasses, but it was actually chronic migraine
with aura. (David Carter for The Washington Post)

Keisha Patterson developed chronic migraine with aura after a car accident in
2014. She was driving to her 2-year-old daughter’s birthday party when the
accident happened and she suffered a concussion.

“One of the first things I noticed was my vision changed,” Patterson, 40, said.
“I was reading something, and I couldn’t see out of my right eye as I normally
would.”

When Patterson experiences aura, it starts small, but gradually her vision
becomes foggier and looks like the glare around a car’s headlight. “It’s almost
like it can blind you in the moment as it progresses,” she said. Her aura looks
like this.



Now, before getting in the driver’s seat, she packs what she calls her “migraine
kit.” It contains items that help manage her migraine triggers, such as light,
smell and sound. The kit includes sunglasses, blue-light-blocking glasses,
purple-tinted glasses, earplugs and tissues to cover her nose. She packs
medications and water, and also checks AccuWeather’s migraine forecast.

“With migraine you always have to stay ready for whatever symptom comes,” said
Patterson, who has visual aura every day, sometimes with migraine pain and
sometimes without. At times, the aura blocks her vision while driving, and she
must pull over and rest her eyes.

Keisha Patterson has visual aura every day at varying intensities and for
different lengths of time. (David Carter for The Washington Post)

To cope with migraine aura, Patterson has dimmed the lights all around her. The
windows in her home are covered by blackout curtains. The brightness on screens
and her car’s dashboard have been lowered. She compares the experience to
“living like a vampire.”

Patterson treats her migraine with Botox injections and Emgality. She still sees
aura every day, but the intensity of it has decreased with the medicine. The
treatments have “turned me around where I can be more functional,” Patterson
said.

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WALKER’S AURA

Walker Young, 46, spends most of his time at home in downtown Toronto watching
what looks like a fireworks show dancing across his vision, like this.



Because of chronic migraine with aura, he took medical leave from his job as a
manager with the City of Toronto. His aura is followed by debilitating headache
pain, extreme fatigue and slurred speech. “I’d say something and people would
look like, ‘What are you talking about?’” Young said. As the migraine stages
progressed, it affected his ability to see, speak and think.

Walker Young, 46, has had chronic migraines with aura at least four days a week
for the past two years, forcing him to go on medical leave from his job as a
manager with the City of Toronto. (Katherine KY Cheng for The Washington Post)

One day, Young’s veterinarian called him to let him know he could pick up his
dog. He happened to be in the midst of a migraine attack. The vet thought he had
been drinking because his speech was slurred and suggested someone else retrieve
the dog.

Young told his neurologist he could find a way to deal with the pain of the
migraine. “It’s the aura,” he told him. “That’s the worst part, because it
affects how you do things and your behaviors.”

Young, out for a walk with his dogs in Toronto. Young has had chronic migraine
with aura at least four days a week for the past two years. (Katherine KY Cheng
for The Washington Post)

His migraine triggers include certain foods, such as chocolate, dairy and
anything high in gluten, and changes in pressure due to the weather.

Young, who lives with his partner and their dogs, also has a number of other
health conditions, including Crohn’s disease and narcolepsy. The latter results
in him sleeping up to 18 hours a day and even longer if he has a migraine.

Young misses work and interacting with people and having a routine. But when he
tried to return to work, his migraine with aura made it difficult to function.

Young, 46, talks with his partner, Derek Chen, 50, at their breakfast table in
Toronto. (Katherine KY Cheng for The Washington Post)

In the past two years, Young has had migraine attacks with aura at least four
days a week. He’s tried every possible migraine medication, including CGRP
drugs, Botox and others. But nothing has worked.

The next step for treatment recommended by his doctor: psychedelics. He hasn’t
decided whether he wants to take that step, and will give Emgality another try
before he does. He’s currently taking Verapamil, a calcium channel blocker used
for blood pressure and heart conditions and is believed to work in migraine by
preventing the constriction of the blood vessels before an attack. He also takes
Ubrelvy, but he said it hasn’t provided relief for him.

He’s not sure when he’ll return to work. For now, he takes advantage of the few
pain-free and aura-free days he has by watching TV, doing puzzles and playing
with the dogs.

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NAHID’S AURA

Nahid Shukralla’s auras are most vivid when her eyes are closed. Sometimes they
wake her from sleep.

Shukralla describes her aura as moving shapes, colors and flashes of light that
she sees in different quadrants of her vision. “The more intense the color is,
that is a more intense aura, and it can wake me up from sleep,” she said. Her
aura looks like this.



Shukralla, who lives in Ottawa, was diagnosed with chronic migraine in 1993. Her
first experience with migraine aura happened while driving on the highway right
before sunset in Chicago. Her husband was asleep in the passenger seat.
Suddenly, her vision became blurry in one eye. She tapped on her glasses,
thinking a lens popped out. But the lens was there.

She closed the eye that was blurry and focused on what she could see out of the
other eye until she could pull over.

Nahid Shukralla at her home in Ottawa. She has suffered from chronic migraine
since 1993. (Jessica Deeks for The Washington Post)

In 2014, Shukralla began creating migraine art by painting images of her aura.
Later in 2020, she learned how to animate her aura, which she shares on her
Instagram account.


Shukralla paints her migraine auras in her home studio in Ottawa. (Jessica Deeks
for The Washington Post)

Since her diagnosis, Shukralla, 60, has tried different medications prescribed
by her doctor to treat migraine, including propranolol, calcium antagonists,
antihistamine antagonists, anti-seizure medications and birth control. “None of
them were helpful,” she said. She has also tried biofeedback and acupuncture,
with no relief.

A collection of Shukralla’s migraine medication. (Jessica Deeks for The
Washington Post) Shukralla injects herself with migraine medication. (Jessica
Deeks for The Washington Post)

In 2018, she tried Aimovig. At the beginning, it worked wonders. “It really
changed my life. I could function more, I could think, achieve more in the day,”
she said.

But then the effects wore off. She switched to Emgality, but it didn’t work as
well, and has since started Vyepti.

“I’m waiting for other medications to be available,” said Shukralla. “I still
get the same amount of migraine, which is more than 15 migraines a month as a
chronic migraineur, but the pain is less severe.”

Sometimes the only refuge when a migraine aura strikes is lying down in a dark
room.

Shukralla rests to soothe her migraine at her home in Ottawa. (Jessica Deeks for
The Washington Post)

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ABOUT THIS STORY

Story editing by Tara Parker-Pope. Video editing by Alexa Juliana Ard and Neeti
Upadhye. Animations by Brian Monroe. Design by Chelsea Conrad. Development by
Audrey Valbuena. Design editing by Christian Font and Matt Callahan. Photo
editing by Maya Valentine. Copy editing by Shannon Croom.


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369 Comments
Alexa Juliana ArdAlexa Juliana Ard is a videographer, producer, editor for
Well+Being at The Washington Post. She was a video editor on The Post's foreign
desk. Before joining The Post, she worked in McClatchy’s D.C. bureau as a
national video producer for the company’s 30 U.S. newsrooms. Twitter|
AddFollow
Brian MonroeBrian Monroe produces animations and motion graphics for The
Washington Post's video team. Twitter


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