What is an aura in epilepsy?

  • October 6, 2020
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Almost 2,000 years ago, an ancient doctor was writing about epilepsy symptoms: “When the doctors asked what the movement into the head was like, [another] boy said ... the movement upwards was like a cold breeze. The word ‘aura’ comes from the ancient Greek word for ‘breeze’ - and it is why we use the word aura in epilepsy today. 

Many people with epilepsy experience aura seizures. They are often seen as a sign that the person will soon have a ‘bigger’ seizure (although people sometimes have an aura without a seizure). What exactly are auras, and what does it mean when you have one?

What is an aura?

An aura is a change in your perception of the world (how you see, hear, feel, taste or smell) that happens to some people with epilepsy or migraines. 

Key facts about auras:

  • Auras normally last between a few seconds and a couple of minutes. 
  • If you have epilepsy, auras are a type of seizure known as a simple partial seizure. In this kind of seizure, you stay conscious (aware of what is happening around you). 
  • For many people, an aura seizure happens before another ‘bigger’ seizure where they lose consciousness. This is why many people think of auras as a ‘warning’.
  • Anyone with epilepsy can have auras, although they are more common in people who have focal epilepsy (which is where seizures start in one specific area of the brain).
  • In one study, 58% of people with focal seizures had auras, while 13% of people with generalized seizures experience them. 

Learn more: The difference between focal and generalized seizures

Aura seizure symptoms

People often find auras hard to describe, and people experience them in different ways. Common aura seizure symptoms include:

  • Visual: flashing lights, blurred vision, some loss of sight, seeing things which are not actually there
  • Smell: unpleasant smells, like rotten eggs
  • Taste: odd tastes like metal, bitterness, or saltiness
  • Sounds: you might hear odd noises like ringing or buzzing, and some people hear songs
  • Feelings: You might experience a range of different feelings, such as lightheadedness, nausea (feeling sick), a rising feeling in your stomach or strong emotions like sadness, joy, panic or fear. 
  • Deja vu: Some people have a sense of deja vu, like they’ve experienced something before. 

Although auras can be difficult to describe, it can be useful for your epilepsy doctor to know about them. This is because you will usually have the same kind of aura each time - and that can tell your doctor which part of the brain your seizures are starting in. 

For example, if you always see flashing lights when you have auras, that could give your doctor a clue about where seizures happen in your brain. 

Can you have an aura without a seizure?

Today, epilepsy experts classify auras as focal aware seizures, which means they are in themselves a kind of seizure. So, if you have epilepsy and you experience an aura, then this counts as a seizure. 

Many people who have auras find that they are like a ‘warning’ of a larger seizure to come. But some people experience an aura without seizure symptoms happening after. It really depends on the individual and the kind of epilepsy they have: 

  • For some people, an aura always comes before a seizure. 
  • Other people only experience auras without seizures developing separately. 

It’s really useful to keep a seizure diary so you can figure out what your pattern is.

Auras in epilepsy can be useful

Everybody’s auras are different. For some people they cause no real issues, but for others auras are scary and make them feel anxious that a bigger seizure is coming on. 

All the same, auras can be useful:

  • They can help your doctor learn more about what is causing your seizures
  • They can help you be safe - by pulling your car over, or just sitting down
  • You can use the time to go somewhere quiet or private for your seizure 
  • You can tell the people you are with that a seizure might come on soon, so they know what to do
  • If you have a Vagus Nerve Stimulator (VNS), you can send an extra dose of nerve stimulation when you have an aura, which may help avoid the seizure too

Seizure tips: Telling people about your seizures

Speak to your doctor about aura seizures

If you experience aura seizure symptoms, speak to your doctor about what they might mean and how you can use them to prepare for ‘bigger’ seizures. 

You can also record your auras in Epsy - this can help your doctor see if there are any patterns in the kinds of auras you have.

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