What You Need to Know About Silent Migraines

How migraines without headache pain can wreak havoc on your health

Woman holding head
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Did you know you could have what's called a silent migraine without actually having a headache? Surprisingly, migraines can occur without the classic pulsing head pain. In fact, about 3 to 5% of people with chronic migraines experience such headache-free migraines, known as "silent migraines." But how can you know when you're having one if you're not in pain?

Silent Migraine Sufferers' Profile

Silent migraines occur in older adults who have previously suffered full migraine symptoms, headache and all. In other cases, adults over age 40 develop these headache-less migraines out of the blue. Here are six names associated with silent migraines:

  • Acephalgic migraine: Acephalgic is the Latin word for "without head pain"
  • Isolated visual migraine
  • Late-onset migraine accompaniment: Occurs when the condition first strikes someone over the age of 40
  • Migraine dissocié: The French name for a migraine that is dissociated from (that is, not related to) headache
  • Migraine equivalent or migraine variant
  • Typical aura without headache

What is a Silent Migraine

To understand if you're having silent migraines, it helps to know a bit about migraines in general and their four phases of a migraine. Actual migraines come in various types and may not include all four phases. You'll know if you're having a silent migraine if you experience everything that comes with a migraine, except the actual headache. Though silent migraines frequently include a prodrome or postdrome phase, they do not involve the phase that, for most individuals, defines a migraine -- the nauseating, throbbing, one-sided head pain.

Visual Changes and Silent Migraines

A silent migraine commonly consists of visual changes that are typical of the aura phase. During a silent migraine episode, you may notice visual symptoms called "positive features," which may include shimmering mirages or stripes, crazy flashes or tiny glittering points of light, or patterns or colors that appear out of nowhere. Frequently, aura symptoms can also involve pins and needles sensations or numbness in the hands, feet, arms, legs or face. In some cases, these visual special effects are so spectacular they can feel like hallucinations. Some literary experts contend that the author Lewis Carroll may have been a migraine sufferer who experienced a crazy, distorted world courtesy of the visual disturbances of the migraine aura, which may account for the fantastic morphing of reality described in his book Alice in Wonderland.

How Long do Silent Migraines Last?

A silent migraine can last from seconds to hours. It can occur as a single, isolated event or may recur as often as several times a day. Just because no headache is involved, individuals experiencing silent migraines are not getting off easily. The visual symptoms of a silent migraine can be extremely disruptive to daily activities, not to mention disconcerting and downright frightening.

Silent Migraines: Triggers and Treatment

Despite its name, a silent migraine may not be all that silent. It is important to consult a physician if you continually experience silent migraine symptoms. Depending on the circumstances, your doctor may run several tests to rule out more serious conditions, such as a transient ischemic attack (a so-called mini-stroke) or seizures. If the frequency of these silent episodes interferes with your daily life, it may be helpful to examine whether any of the traditional migraine triggers instigate your symptoms. Migraine triggers vary widely -- from skipped meals or skimping on sleep to unchecked stress or emotion, or even to specific foods. If diligently avoiding your triggers does not quell the severity or frequency of your silent migraines, a variety of medications, both prescription medications, and over-the-counter medications , are available. Over-the-counter anti-inflammatory drugs (such as ibuprofen or aspirin), high blood pressure medicines (such as beta-blockers or calcium channel blockers) or antidepressants, may help alleviate your symptoms.

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Article Sources
  • Headache Fact Sheets. National Headache Foundation. http://www.headaches.org/headache-fact-sheets/
  • Types of Migraine. American Migraine Foundation. https://americanmigrainefoundation.org/understanding-migraine-cat/types-of-migraine/