Migraine aura progression often follows which pattern?

• A. Zigzag lines that turn into checkerboard patterns
• B. Dark spots that expand into circular shapes
• C. Sudden loss of all sensory input
• D. Auditory hallucinations preceding headaches

Answer: (A)

Visual migraine aura most often progresses as a fortification spectrum: an initial small scintillating zigzag line that expands across the visual field and can morph into a checkerboard or fortification pattern. This evolution mirrors the wave of cortical spreading depression moving across the occipital cortex, producing evolving visual symptoms over several minutes and typically before the headache begins. The zigzag lines turning into a checkerboard pattern best captures this well-described progression. Other options describe phenomena not characteristic of migraine aura: simple dark spots or scotomas don’t usually develop into the complex evolving pattern; a sudden loss of all sensory input isn’t typical aura; and auditory hallucinations aren’t a common feature of migraine aura, which is primarily visual (with possible sensory or language disturbances).