By: Nowshin Yeasmin Nishat
Understanding Seizure Auras: The Warning Signs Before a Seizure
What Is an Aura?
If you talk to enough people with epilepsy, you’ll hear the same thing again and again: seizures don’t always come out of nowhere. Often, there’s a moment right before a strange feeling, a flicker in the senses, a wave of déjà vu that tells them something is about to happen. Doctors call this an aura.
An aura happens when abnormal electrical activity starts up in one particular part of the brain. Depending on where that activity begins, it can show up as a smell that isn’t there, a burst of fear, a tingling sensation, or a feeling that’s almost impossible to put into words. Some people experience changes in memory, emotions, sensation, or perception depending on the brain region involved (Engel, 2013; Fisher et al., 2017).
Technically, an aura is itself a small seizure, what’s known as a focal aware seizure, meaning the person stays conscious and knows exactly what’s going on around them. For some people, that’s the whole event; the aura comes and goes and nothing more happens. For others, it can be the beginning of a seizure that spreads and becomes something larger (Fisher et al., 2017).
Either way, being able to recognize your own aura is genuinely useful. It may provide time to sit down, move to a safer environment, or alert someone nearby before a possible seizure progresses (Epilepsy Foundation, 2025).
Why Do Auras Happen?
At the root of it, an aura is caused by abnormal electrical activity in a specific region of the brain, and the experience depends largely on which area of the brain is involved (Engel, 2013). For example, if seizure activity begins near brain regions involved with memory and emotion, a person may experience fear, anxiety, or déjà vu. If it begins in areas responsible for vision, they may experience flashing lights, visual patterns, or other changes in perception (Engel, 2013). Auras are most commonly associated with focal epilepsy, where seizures begin in a specific area of the brain rather than involving both hemispheres from the beginning (Fisher et al., 2017).
Several factors may increase the likelihood of seizures in some individuals, including:
- Skipping a dose of seizure medication
- Lack of sleep
- Stress or emotional changes
- Illness or fever
- Alcohol use
- Hormonal changes
- Low blood sugar
- Certain visual triggers
However, triggers vary greatly between individuals. Keeping a seizure diary can help patients and healthcare providers identify possible patterns and improve seizure management (Kwan & Brodie, 2000).
What Auras Can Feel Like
No two auras feel exactly alike. The symptoms a person experiences usually depend on the location of abnormal electrical activity in the brain (Engel, 2013).
Sensory: tingling, numbness, sudden warmth or cold, unusual bodily sensations, or dizziness.
Visual: flashing lights, bright spots, blurred vision, or shapes and patterns that are not actually present.
Auditory: ringing, buzzing, voices, or sounds that others cannot hear.
Smell and taste: unusual smells, such as burning odors, or strange tastes, such as a metallic sensation.
Emotional: sudden feelings of fear, panic, happiness, or sadness without an obvious reason.
Memory and thinking: déjà vu, unfamiliar feelings toward familiar places, difficulty finding words, or confusion.
Physical: nausea, a rising feeling in the stomach, sweating, changes in heart rate, chills, or flushing.
These different experiences occur because different areas of the brain control different functions, including sensation, memory, emotion, and movement (Engel, 2013).
Does an Aura Always Turn Into a Bigger Seizure?
Not always, but sometimes, yes.
If abnormal electrical activity remains limited to one area of the brain, the aura may be the entire seizure, and the person remains aware throughout. However, if the electrical activity spreads to both sides of the brain, it may progress into a focal-to-bilateral tonic-clonic seizure (Fisher et al., 2017).
Many auras do not progress into larger seizures and may end on their own. The experience varies greatly depending on the individual and the type of epilepsy they have (Engel, 2013).
How Long Does an Aura Last?
Auras are usually brief and may last from a few seconds to a few minutes. The exact duration differs from person to person and may also vary between seizures in the same individual (Fisher et al., 2017). If an aura changes significantly, lasts longer than usual, or involves new symptoms, it is important to discuss this with a healthcare provider.
Can You Prevent Them?
Auras cannot always be completely prevented because they result from changes in brain activity that are not fully under voluntary control. However, proper seizure management can reduce the frequency of seizures and auras for many people (Kwan & Brodie, 2000).
Helpful strategies may include:
- Taking seizure medication exactly as prescribed
- Maintaining regular sleep patterns
- Managing stress
- Eating regular meals
- Staying hydrated
- Avoiding known personal triggers
- Attending regular medical appointments
Keeping a seizure diary can also help healthcare providers understand patterns and adjust treatment when necessary (Kwan & Brodie, 2000).
If You Feel an Aura Coming On
If you recognize that an aura is beginning, the goal is not necessarily to stop it, but to improve safety and reduce the risk of injury.
Helpful steps include:
- Moving away from dangerous areas such as stairs, traffic, water, or sharp objects
- Sitting or lying down in a safe place
- Informing someone nearby
- Following an individual seizure action plan
- Using prescribed rescue medication if recommended by a doctor
(Epilepsy Foundation, 2025)
If Someone Near You Is Having One
If someone appears to be experiencing an aura:
- Stay calm and remain with them
- Help them move to a safe area
- Encourage them to sit or lie down
- Remove nearby hazards
- Speak calmly and reassure them
- Observe what happens during the episode
Do not restrain the person and never place anything in their mouth. These actions can increase the risk of injury (Epilepsy Foundation, 2025).
When to Call a Doctor or 911
A person should contact their healthcare provider if:
- Auras become more frequent
- Symptoms change
- Medication appears less effective
- New symptoms develop
- Seizures become more difficult to control
Emergency medical help should be called if:
- A seizure lasts longer than five minutes
- Multiple seizures occur without recovery
- The person has difficulty breathing
- A serious injury occurs
- It is the person’s first seizure
(Epilepsy Foundation, 2025)
Clearing Up a Few Myths
“An aura isn’t a real seizure.”
False. An aura is considered a focal aware seizure caused by abnormal electrical activity in the brain (Fisher et al., 2017).
“Everyone with epilepsy gets auras.”
False. Not everyone with epilepsy experiences auras.
“Every aura becomes a bigger seizure.”
False. Some auras remain isolated and do not progress.
“Can you just force it to stop?”
No. Seizures are caused by changes in brain activity, not a lack of willpower or control.
Staying Safe Day to Day
People who experience auras regularly may benefit from creating a seizure safety plan. This may include:
- Educating family and friends about seizure symptoms
- Teaching others basic seizure first aid
- Carrying medical identification if recommended
- Avoiding high-risk situations such as swimming alone or working near dangerous equipment
- Keeping emergency contacts available
A safety plan can provide confidence and support for both individuals with epilepsy and their caregivers (Epilepsy Foundation, 2025).
The Bottom Line
An aura is a neurological experience caused by abnormal electrical activity in a specific area of the brain. Because different brain regions control different functions, auras can affect emotions, senses, memory, and physical sensations in many different ways (Engel, 2013).
Although an aura does not always develop into a larger seizure, recognizing personal warning signs can help individuals take precautions and improve safety. With appropriate medical care, awareness, and support, many people with seizure auras are able to manage their condition and maintain their quality of life.
References
Engel, J. (2013). Seizures and epilepsy. Oxford University Press.
Epilepsy Foundation. (2025). Seizure first aid and safety information. https://www.epilepsy.com
Fisher, R. S., Cross, J. H., French, J. A., Higurashi, N., Hirsch, E., Jansen, F. E., Lagae, L., Moshé, S. L., Peltola, J., Roulet Perez, E., Scheffer, I. E., & Zuberi, S. M. (2017). Operational classification of seizure types by the International League Against Epilepsy: Position paper of the ILAE Commission for Classification and Terminology. Epilepsia, 58(4), 522–530. https://doi.org/10.1111/epi.13670
Kwan, P., & Brodie, M. J. (2000). Early identification of refractory epilepsy. New England Journal of Medicine, 342(5), 314–319. https://doi.org/10.1056/NEJM200002033420503
