A seizure is an abnormal electrical activity in the brain that suspends normal function. Seizures can involve involuntary movements such as shaking, convulsions, and changes in behavior and feelings. Before it occurs, some people experience a recognizable sensation known as an aura seizure.
We make it easy for you to participate in a clinical trial for Epilepsy, and get access to the latest treatments not yet widely available - and be a part of finding a cure.
An aura is a subjective sensation experienced by a person before a condition (e.g., seizure or migraine) affects the brain. Because of this, people with epilepsy often consider auras a warning sign before a seizure occurs.
An aura is technically a focal seizure with sensory or psychic symptoms. As such, they’re termed focal onset aware seizures.
Although classically associated with focal epilepsy, auras have also been shown¹ to occur in patients with generalized epilepsy that affect the whole brain.
One hypothesis is that these auras or focal seizures spread through the hyperexcitable brain regions causing a “full” seizure. In these instances, auras are considered the first stage of a seizure, which is why they’re a warning sign.
One study² found that 58% of people with focal seizures experienced auras, while 13% of people with generalized seizures also had auras beforehand.
Not everyone experiences an aura before having a seizure. Some people may also experience an aura without having a generalized seizure afterward.
Auras can occur a few seconds to an hour before a seizure occurs. Auras can last from two to seven minutes, but in most cases, they are just under a minute long.
Most people can tell when they’re experiencing an aura because it tends to have a recognizable pattern. Interestingly, one study has shown greater reporting of auras dependent on a patient’s lifetime count of grand mal seizures, as patients may get progressively familiar with the feeling of an aura with every seizure.
Sometimes, it can be difficult for people to describe their aura. Some people may say that auras feel “strange” or have “out of body” experiences—but it depends on the person and can be different for everyone.
The symptoms of an aura vary widely but typically involve unusual physical movements, physical experiences, sensory changes, and sudden emotional changes.
People generally stay fully conscious, awake, and alert during an aura. However, not everyone remembers having it afterward.
The potential symptoms of an aura include visual changes, olfactory hallucinations, taste changes, hearing changes, gastrointestinal problems, and physical and muscular sensations.
Here are some of the things you might notice when you get an aura seizure:
Visual disturbances experienced in an aura can include:
Seeing bright colors, zigzag lines, flashing lights, or dark spots
Loss of sight
Someone with an aura may smell something unexpected, indescribable, or unpleasant in their surroundings that aren’t there in reality. When you experience this, you might have olfactory hallucinations related to an aura seizure.
An aura can cause someone to have an altered sense of taste, such as bitterness in the mouth.
Auras can cause an altered sense of sound, which may include:
Hearing voices (auditory hallucinations)
Having buzzing or ringing in the ears
Loss of hearing
Gastrointestinal problems caused by an aura can include:
A rising sensation from the stomach to the throat (which is similar to the feeling someone may get when riding a roller coaster)
Someone with an aura may experience physical sensations on one or both sides of the body. These may include:
Making repetitive muscle movements
Feeling pain or stiffness in the face, head, and limbs
Involuntary movement of the head or eyes to the side
Experiencing a tingling feeling or numbness
Some other feelings people get during auras include:
A headache or feeling lightheaded or dizzy
Vertigo (the sensation of spinning or feeling off balance), a false sense of movement
Difficulty with speech (aphasia)
Shortness of breath
In addition to the range of physical and sensory changes, people can also experience emotional symptoms during an aura.
These symptoms often come on quickly and can include:
Sadness or depressed mood
Anxiety, fear, or racing thoughts
Pleasant thoughts, euphoria, or joy
Feeling detached from reality, or like the self and body are separate (derealization)
Feeling unfamiliar with a person or situation that is familiar in reality
Having the feeling that something has happened before (déjà vu)
Jamais vu, or a very familiar person, place, or situation that is suddenly strange or unfamiliar
The specific symptoms someone experiences during an aura can depend on where exactly the aura occurs in the brain. It’s helpful to take note of your symptoms, as doing so may help your doctor understand where your seizures occur.
Here’s where auras occur in your brain:
The frontal lobe is located just behind the forehead at the front of the brain.
An aura in the frontal lobe often causes physical symptoms. This includes involuntary muscle twitching or stiffening, automatisms (e.g., leg bicycling, pelvic thrusting), vocalizations, or a Jacksonian March.
The temporal lobes are located at the sides of the brain, right behind the ears.
A focal aware seizure, or an aura, in the temporal lobe, can include déjà vu, having an unusual sense of smell, sound, or taste, and sudden emotional changes. There may also be automatisms such as fidgeting with hands, chewing, or lip-smacking.
The parietal lobe is located near the brain’s center, right behind the frontal lobe. Seizures from this area are uncommon and poorly defined.
Auras in the parietal lobe usually cause numbness or tingling in a lateralized fashion; however, they are not specific or sensitive. People may feel their limbs are bigger or smaller than usual, and they may have out-of-body experiences and anxiety.
The occipital lobe is located at the back of the head, and seizures from this area are relatively uncommon, representing less than 3%³ of seizures. Occipital lobe seizures, however, can occur as benign focal epilepsy of childhood.
Auras in the occipital lobe typically cause visual disturbances and hallucinations since this lobe contains the visual cortex. However, experiential, abdominal, and somatosensory phenomena are also common.
Auras can be confused with other experiences that are related to seizures. It’s essential to understand the difference between auras and these other experiences.
The prodrome phase, like an aura, precedes a seizure. While the symptoms of the prodrome phase can be very similar to symptoms experienced in an aura, there are differences.
The critical difference is that the aura typically occurs seconds to minutes before a seizure and helps localize where the seizure occurs and identifies a seizure. The premonitory symptoms, however, occur more than 10 minutes before a seizure and can precede a seizure by days.
There are also two classes of prodromal symptoms—sudden and recurring, such as body jerks, dreamy state, or yawning, and continuous, such as lethargy or irritability.
An aura, or a simple focal seizure, can lead to a complex or generalized seizure. In a “larger” seizure, someone may have the following experiences:
Loss of consciousness and unresponsiveness; however, the person generally stays conscious during an aura, even though they may not remember it after the fact
Severe symptoms, such as biting the tongue, dilated pupils, difficulty breathing, or loss of bladder control
Clusters of generalized seizures, such as back-to-back absence seizures or a buildup of myoclonic jerks; people usually only have one aura before a seizure
It would be best if you prepared to experience a generalized seizure when you get an aura seizure. This can involve the following:
Getting into a safe location
Sitting or lying down
Moving objects out of the way
Calling out for help if other people are around
Trying to stay calm
When an aura occurs, it is unlikely that you’ll be able to stop a larger seizure from happening. However, following safety advice helps reduce the negative impact of the seizure.
Having an aura can be a frightening experience and can cause people to worry about the larger seizure that will probably follow. However, auras are an excellent warning sign as they help people prepare and increase their safety during a seizure.
Auras are experienced in different ways by people with epilepsy. However, each person tends to have a regular pattern of their auras, which makes them easy to recognize.
Some of the most commonly asked questions about epileptic seizures with auras follow:
No. An aura is part of a seizure—a simple focal aware seizure that affects a small, localized part of the brain. However, you can have focal seizures without generalized seizures. Although those present similarly to auras, they would be considered focal seizures in and of themselves.
An aura happens when the electrical activity in the brain changes. The specific reasons for why this happens to differ between people with epilepsy. Some triggers in susceptible people include repetitive sounds, flashing lights, sleep deprivation, and fever.
Focal aware seizures | Epilepsy Society
Seizures and epilepsy: Frequently asked questions | Brain Line