Auras are subjective and may be sensory or experiential. They
reflect the initial seizure discharge. An aura may be an isolated
phenomenon or progress to a focal seizure with objective features
(with or without altered awareness) or to a bilateral convulsion. An
aura is also known as a "warning".
A sensory aura involves a sensation without an
objective clinical sign. Sensory aura include the following types:
- Somatosensory aura are characterized by
sensory phenomena including tingling, numbness, electric-shock
like sensation, pain, sense of movement, or desire to move. Somatosensory
aura occur in seizures involving the sensorimotor cortex.
- Visual aura are characterized by elementary visual hallucinations such as
flashing or flickering lights, spots or other shapes, simple
patterns, scotomata, or amaurosis. More complex visual
hallucinations such as seeing formed images are considered
experiential aura. Visual aura occur in seizures involving the
occipital lobe, and are often colored in nature.
- Auditory aura are characterized by
elementary auditory phenomena including buzzing, ringing, drumming
or single tones. More complex auditory hallucinations such as voices
are considered experiential seizures. Auditory aura occur in
seizures involving auditory cortex in the lateral superior temporal
- Olfactory aura are characterized by
olfactory phenomena - usually an odor, which is often unpleasant.
Olfactory aura occur in seizures involving the mesial temporal
or orbitofrontal regions.
- Gustatory aura are characterized by
taste phenomena including acidic, bitter, salty, sweet, or metallic
tastes. Gustatory aura occur in seizures involving the parietal
operculum and the insula.
- Epigastric aura are characterized by
upper abdominal phenomena including discomfort, emptiness,
tightness, churning and a sensation that may rise up to the chest or
throat. Epigastric aura occur in seizures involving the mesial temporal lobe.
- Cephalic aura are characterized by a
sensation in the head such as light-headedness or headache.
An experiential aura involves affective, mnemonic (memory) or
perceptual subjective phenomena including depersonalization and
hallucinatory events; these may appear alone or in combination.
Experiential aura include the following types:
- Affective aura are characterized by
phenomena such as fear, depression, joy and anger.
- Mnemonic aura are characterized by
memory phenomena such as feelings of familiarity (déjà vu) and
unfamiliarity (jamais vu).
- Hallucinatory aura are characterized by imagined
complex sensory phenomena that may involve visual (e.g. formed
images), auditory (e.g. hearing voices) or other sensory modalities,
without change in awareness. The sensory phenomena may be
accompanied by associated emotion or interpretation e.g. may be
experienced as persecutory.
- Illusory aura are characterized by an
alteration of actual perception involving visual, auditory,
somatosensory, olfactory, and/or gustatory phenomena, without change