Some people develop migraine episodes that don’t cause headache pain. These are often called “silent migraine.” Even though they don’t cause physical pain, silent migraine may trigger other symptoms that can be debilitating.
If you have migraine, you may know how painful the condition can be. For many people, the symptoms of a typical migraine episode include sharp pain that may not subside for hours. But for others, the condition may have different symptoms.
Classic migraine may be accompanied by symptoms other than a headache. Some people experience aura — visual disturbances and sensory symptoms — before pain hits.
Silent migraine occurs when you have aura symptoms without a headache. Experts believe that about
Aura symptoms are often progressive over up to
Aura symptoms may include:
- blurry vision
- light sensitivity
- vision loss
- seeing zigzags or squiggly lines
- numbness
- tingling
- weakness
- confusion
- difficulty speaking
- dizziness
- diarrhea
- vomiting
- abdominal pain
How long can a silent migraine last?
Silent migraine episodes typically last from a few minutes up to an hour. Some people have chronic migraine that lasts for days, weeks, or months, but this isn’t typical for silent migraine.
Because migraine is usually associated with significant pain, silent migraine may seem like a paradox. Experts think genetics may play a role, but it’s unclear exactly why they occur.
Migraine may result from the brain’s difficulty adjusting to sensory stimulation such as lights and noise. Changes in chemicals and blood vessels in the brain may also be factors.
Over time, most people figure out what triggers their migraine. The triggers may be environmental, dietary, or physiological. Some of the hundreds of potential migraine triggers include:
- odors
- noises
- bright lights
- fermented foods
- caffeinated drinks
- alcohol
- barometric changes
- chemical preservatives, colorings, and flavorings
- stress
- hunger
- exercise
- pain
- eyestrain
- neck problems
- sinus problems
- too much sleep
- too little sleep
- menstruation and other hormonal changes
Some medications may also cause migraine, such as oral contraceptives and medications that open the blood vessels (vasodilators).
Your migraine risk, silent or otherwise, is higher if you:
- have a family history of migraine
- are female
- are menstruating, pregnant, or going through menopause
Although migraine is more common in people under 40 years of age, aura without headache may be more common later in life, according to the American Migraine Foundation.
Aura symptoms may mimic symptoms of other serious conditions such as ministrokes, strokes, and meningitis. For this reason, you shouldn’t self-diagnose a silent migraine. If you experience signs of aura for the first time, contact a doctor to get a diagnosis.
A doctor may be able to diagnose silent migraine (officially “typical aura without headache”) based on your family history and a physical exam. If the symptoms are severe or new, they may order tests such as:
- blood tests
- CT scans
- MRI scans
- a spinal tap
If your migraine is infrequent, short in duration, and not severe, you may not need treatment. If they often happen and affect your ability to perform daily tasks or enjoy life, you might consider treatment options.
There’s no cure for migraine, but medication can help control symptoms. Treatments for silent migraine are the same as those for migraine with headaches.
Over-the-counter medications, such as the following, may help treat the symptoms of acute migraine:
Though caffeine may be a migraine trigger, it may also help ease acute migraine symptoms.
Some people find drinking a cup of coffee or taking medications with caffeine helps. If you get silent migraine accompanied by nausea and vomiting, a doctor may prescribe anti-nausea medications.
If you experience migraine often, a doctor may advise you to take preventive medications. These include:
- beta-blockers, such as propranolol or metoprolol
- calcium channel blockers, such as verapamil or diltiazem
- tricyclic antidepressants, such as amitriptyline or nortriptyline
Some prescription migraine treatments have side effects. For this reason, some people try alternative treatments before prescription drugs. Alternative options may include:
- biofeedback
- massage therapy
- behavioral therapy
- acupuncture
These treatments are often effective in easing stress, which can be a migraine trigger. They may also relieve acute episodes.
Your first step in preventing silent migraine is to identify your triggers. To do this, keep a migraine diary and write down:
- when each episode occurred
- how long it lasted
- what you were doing before and when it struck
Be sure to note any foods or beverages you consumed, as well as any medications you took before the migraine episode began.
Once you’ve identified your triggers, you should avoid them. This may mean modifying your diet or avoiding noisy social situations.
If stress is a trigger for you, try practicing stress management techniques such as writing in a journal, meditating, or doing exercises such as yoga.
Consider these steps to get on a regular sleep schedule and prevent insomnia:
- Go to bed at the same time each night.
- Avoid caffeine and other stimulants.
- Keep your bedroom cool and dark at night.
- Consider investing in a fan or white noise machine to block out noises that may keep you awake.
If you smoke, quitting may help
Silent migraine refers to experiencing migraine aura without headache pain. Because you experience aura symptoms without pain, you may dismiss the symptoms as eyestrain or stress. Since the symptoms may not be obvious, silent migraine may be underreported and undermanaged.
Silent migraine varies in how much it affects day-to-day life. Some people experience episodes rarely, in short duration, and with few symptoms. Others experience them daily with severe symptoms.
If you have silent migraine and suddenly develop a terrible headache, confusion, weakness, or other aura symptoms that aren’t typical for you, get emergency medical help to rule out a stroke or other neurological condition.
Contact a doctor if you think you have silent migraine. Once you receive a diagnosis, you can review treatment options and make lifestyle changes to manage triggers. Talking with others who understand what you’re going through can also help you better identify and manage silent migraine.