What Is a Persistent Aura Without Infarction?

An Aura That Will Not Go Away

Migraines have several complications.
Migraines have several complications. PhotoAlto/Alix Minde/Getty Images

There are a number of rare complications of migraines, and persistent aura without infarction (PMA) is one of them. As the name suggests, migraine aura is a necessary feature of PMA.

Major Feature of Persistent Aura Without Infarction

The most important feature of persistent aura without infarction is the migraine aura itself. An aura is a reversible neurological disturbance (classically visual) that may precede or accompany a migraine headache.

Typical migraine auras last within 5 to 60 minutes, but in PMA, a person's aura persists for a week or more. Also, the persistent aura is not due to any problems with the brain. So a CT or MRI of the brain will show no evidence of stroke — as it would in another migraine complication, called migraine infarction (migraine stroke).

What are the Symptoms of a Migraine Aura?

Many people experience some change in their vision during an aura. Visual changes can include:

Even though many auras involve a person's vision, they may experience other symptoms as well, like speech or sensory disturbances.

Other Symptoms that Signal a Migraine

Other symptoms that may signal the onset of a migraine are called premonitory symptoms. They usually begin hours to days before the headache and should not be confused with an aura, which is transient and causes neurological symptoms.

Premonitory symptoms include:

  • Loss of appetite or food craving
  • Change in activity (more or less active)
  • Low mood
  • Yawning a lot
  • Pain
  • Neck stiffness
  • Fatigue

Treating Persistent Aura without Infarction

Treatment for a migraine aura begin with treating the migraine itself. In most cases, routine abortive migraine treatments will work for your usual migraine with aura.

If the aura continues after the migraine, however, there is little that can be done. There are some reports that treating PMA with acetazolamide or valproic acid may be helpful. A 2010 review study in Headache found that the anti-seizure medication Lamictal (lamotrigine) may be the most effective for treating PMA

Bottom Line

If you have a migraine aura that lasts longer than usual (like more than an hour) be sure to contact your health care provider so you can be evaluated. He or she will want to rule out other more serious medical issues, like a stroke, before deciding that you have persistent aura without infarction.


Headache Classification Committee of the International Headache Society. "The International Classification of Headache Disorders: 3rd Edition (beta version)". Cephalalgia 2013;33(9):629-808.

Kantor, Daniel. Migraine with Aura. U.S. National Library of Medicine and the National Institutes of Health. 

Olesen, J. “Understanding the Biologic Basis of Migraine.” NEJM. 22 Dec, 1994.

Thissen, S., et al. Persistent migraine aura: new cases, a literature review, and ideas about pathophysiology. Headache, 2014 Sep;54(8):1290-309.

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