Other Persistent Non-Visual Symptoms
Type: Persistent aura symptom — may last weeks, months, or years. Often bilateral (affecting both sides of vision or both ears). Rare but well-documented.
What is it?
This file covers less common persistent non-visual symptoms that do not fit neatly into the main symptom categories. While individually rare (reported by 1 to 3 subjects each), collectively they show the remarkable diversity of neurological experiences that can persist after migraine aura begins. These include somatosensory, motor, olfactory, language, and sensory integration symptoms.
What it feels like
Hyperawareness of reflections, shadows, and body parts is an intrusive, persistent attention to things that would normally be background awareness—you notice reflections in every surface or constantly sense your own body parts in a way that feels abnormal or annoying. Muscle twitching is the persistent, involuntary contraction or fasciculation of muscles, distinct from the temporary twitching that may occur during migraine attacks. Bilateral somatosensory symptoms involve tingling or numbness that appears on both sides of the body simultaneously, persisting for weeks or longer. Olfactory hallucinations are persistent phantom smells—unpleasant or unusual odors that are not present in the environment. Hyposmia is a persistent reduction in the ability to smell, making food taste bland and reducing your ability to detect odors. Aphasic disturbances involve persistent difficulty finding words, expressing thoughts clearly, or understanding language, creating a barrier to communication.
How patients describe it
“I used to smell things that weren’t there and have things taste funny, too. This was back when my migraines were much worse. One night I was repeatedly awoken by the smell of freshly ground coffee. The smell was so strong I thought I might go crazy.” — P.H.B.
“I have a funny taste before and during my migraines, but I don’t think of it as metallic. It tastes bitter and smoky, and feels almost like the back of my tongue is stinging.” — L.T.B.
“I have recently started suffering from migraines… I couldn’t breathe too well and had to sit down on the floor. My hands felt like they were vibrating, and I felt dizzy… My speech was slurred.” — D.G.
What makes it worse
These symptoms often worsen during migraine attacks or in the days following migraine activity. Stress, fatigue, and lack of sleep can intensify somatosensory symptoms and speech difficulties. For olfactory symptoms, exposure to strong smells or olfactory triggers may worsen phantom smells. Physical exertion may exacerbate muscle twitching in some cases. Focusing attention on the symptoms can make them feel worse.
What may help
Stress reduction, adequate sleep, and regular rest help manage most of these symptoms. For somatosensory symptoms, some patients benefit from gentle movement, stretching, or physical therapy. For muscle twitching, magnesium supplementation is sometimes helpful (though this should be discussed with a healthcare provider). For olfactory symptoms, minimizing exposure to strong smells and using fragrance-free products in the home may help. For language difficulties, speech-language pathology consultation may provide strategies to support communication. Cognitive behavioural therapy and mindfulness can help patients manage the distress associated with these symptoms. Distraction and acceptance strategies often prove helpful.
Related symptoms
- Cognitive problems or brain fog
- Somatosensory symptoms (tingling or numbness)
- Speech and language difficulties
- Synaesthesia (cross-wiring of senses)
Clinical note
These symptoms are individually rare but highlight the full neurological spectrum of persistent aura. Bilateral somatosensory symptoms are reported by 2 of 60 subjects, muscle twitching by 3 subjects, olfactory hallucinations and hyposmia by 2 subjects each, and aphasic disturbances by 2 subjects. Neurological evaluation helps document and characterize these symptoms and rule out other causes. A normal brain MRI and EEG support the diagnosis of persistent aura without infarction. Many of these symptoms improve or stabilize over time with appropriate management and reassurance. Speech-language pathology, neurology, and mental health support can help patients adapt and function despite these unusual symptoms.
If this is the first time you experience these symptoms, or they feel different from previous episodes, seek medical evaluation to rule out other causes.