The Answers to Silent Migraine

Symptoms and diagnosis for Silent Migraine
Neuro

By Neurosurgery Singapore

What is a Silent Migraine?

A silent migraine is a migraine aura without headache. About 25 to 30% of migraine sufferers have migraine with aura. An aura is a warning sign of an impending migraine. Auras can be visual, sensory, motor or verbal disturbances. However, most people experience an aura with visual symptoms. In most cases, a headache follows the aura. In silent migraines, the aura occurs without headache. This type of migraine is relatively rare, affecting about 5% of migraineurs. Other names for it include acephalgic migraine and migraine without head pain.

There are four phases of a migraine—prodrome, aura, headache attack, and postdrome. Silent migraines have symptoms in each phase except headache pain during the attack phase. Common symptoms during the aura phase include light sensitivity, vision changes, and other neurological changes, such as dizziness. A prodrome might precede these symptoms. Subtle changes, such as mood changes or fatigue, may occur. Afterwards, postdrome symptoms may persist for up to a day.

People who get silent migraines are likely to suffer from other types of migraine as well. Migraine disorders are more common in women and people with a family history. Migraines tend to start during adolescence, peak during young adulthood, and decline with age. However, silent migraines can become more common as migraineurs get older.

The symptoms silent migraine causes can resemble serious and potentially life-threatening conditions. This includes TIAs (transient ischemic attacks), stroke, and seizures. Seek immediate medical care if you have unexplained visual changes or neurological problems, such as numbness, tingling or paralysis.

What are some symptoms of Silent Migraine?

For Silent Migraine, you can have symptoms that go along with any phase of a migraine, but without the classic pain around your temples.

During the phase that warns you a migraine is coming, called the prodrome phase, you could:

  • Get “hyper” or cranky
  • Have food cravings
  • Be tired and yawn more
  • Feel stiff, especially in your neck
  • Need to pee more often
  • Get constipated or have diarrhea

Next, the aura phase usually lasts about an hour. It’s best known for its unusual visual symptoms, such as seeing:

  • Wavy or jagged lines
  • Flashing lights
  • Dots or spots in your vision
  • Blind spots
  • Tunnel vision

But it can also affect your other senses, movement, and speech. You may have:

  • Trouble hearing, or hear things that aren’t there
  • Strange smells or tastes
  • Numbness, tingling, or a pins-and-needles feeling
  • Weakness
  • Trouble remembering or saying a word

Even though your head doesn’t hurt, a silent migraine may affect your body in other ways:

  • Upset stomach or vomiting
  • Hot flashes and chills
  • Stuffy or runny nose
  • Dizziness or spinning 
  • Sore neck or jaw
  • Sensitivity to light, sounds, smells, touch, or motion
  • Confusion

Afterward, you may feel wiped out and have the blahs for as long as a day.

Not all migraine attacks follow the same pattern. Even for the same person, the symptoms can be unpredictable.

“Since the symptoms may not be obvious, silent migraines may be underreported and undermanaged. Contact our specialist if you think you have silent migraines. Once you receive a diagnosis, you can review treatment options and begin to make lifestyle changes to manage triggers.”

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What types of diagnosis?

If you have migraines or a family history of such cases, our doctor trained in treating headaches (neurologist) will likely diagnose them based on your medical history, symptoms, and a physical and neurological examination.

More tests maybe recommended to rule out other possible causes for your pain if your condition is unusual, complex or suddenly becomes severe.

    • Blood tests. To test for blood vessel problems, infections in your spinal cord or brain, and toxins in your system.
    • Magnetic resonance imaging (MRI). A MRI uses a powerful magnetic field and radio waves to produce detailed images of the brain and blood vessels. It can help doctors diagnose tumors, strokes, bleeding in the brain, infections, and other brain and nervous system (neurological) conditions.
    • Computerized tomography (CT) scan. A CT scan uses a series of X-rays to create detailed cross-sectional images of the brain. This helps doctors diagnose tumors, infections, brain damage, bleeding in the brain and other possible medical problems that may be causing headaches.
    • Spinal tap (lumbar puncture). Our doctor may recommend a spinal tap (lumbar puncture) if he or she suspects infections, bleeding in the brain or another underlying condition. A thin needle is inserted between two vertebrae in the lower back to remove a sample of cerebrospinal fluid for analysis in a lab.

Living with Silent Migraines

Silent migraines can impact a person’s quality of life, especially if they are severe or occur frequently. Even though silent migraines do not cause pain, the other symptoms may be debilitating.

Medications and lifestyle changes can help manage symptoms. Migraine episodes tend to become milder and less frequent with age.

Anyone with symptoms of a migraine, silent or otherwise, should see our doctor for advice and treatment.

Work with us to take back control. Document when you get relapses and what you were doing and eating. Keep a record of what the weather was like and if you were exposed to unusual smells or environments. Because knowing your triggers can help you prevent migraines. Our Neurologist may prescribe different medicines or combinations of medicines. Doing this helps sort out which will be most effective for preventing or stopping them when they start.

Call our Specialists!