What characterizes a migraine with visual aura?

A migraine with visual aura is characterized by specific visual disturbances that can precede or accompany the headache phase. One of the most common types of visual aura is scintillating scotoma, which involves transient visual phenomena such as flashing lights or zigzag patterns, often leading to a temporary blind spot in the vision. This type of aura arises from cortical spreading depression, which disrupts normal neural activity in the visual cortex.

The presence of scintillating scotoma is significant in diagnosing a migraine with aura, as it differentiates it from other headache disorders and provides insight into the neurophysiological mechanisms at play during the migraine attack. Recognizing this visual aura is essential, as it can help in the appropriate management and treatment of migraines.

The other options do not accurately reflect the defining features of a migraine with aura, making them less relevant in this context.