When most people think of migraines, they imagine a severe, throbbing headache. However, not all migraines involve head pain. Silent migraines, also known as acephalgic migraines, are a type of migraine that causes typical migraine symptoms - such as visual disturbances, nausea, and dizziness - without the intense headache. Because they lack the hallmark migraine pain, silent migraines can be difficult to recognise and diagnose.
What Is a Silent Migraine?
A silent migraine follows the same neurological process as a traditional migraine but without head pain. Instead, sufferers experience other migraine symptoms, particularly the aura phase, which includes visual disturbances, sensory changes, or cognitive issues. Silent migraines can last anywhere from a few minutes to several hours, and although they do not cause pain, they can be disruptive and distressing.
People who experience silent migraines may not even realise they are having a migraine, leading them to confuse their symptoms with other conditions such as strokes, seizures, or anxiety attacks.
Symptoms of a Silent Migraine
Since silent migraines do not include head pain, recognising them depends on other migraine symptoms. These may include:
- Visual disturbances (flashing lights, zigzag lines, blind spots, or blurry vision)
- Dizziness or vertigo
- Nausea or vomiting
- Sensitivity to light, sound, or smells
- Numbness or tingling in the face or limbs
- Difficulty speaking or confusion
- Fatigue and brain fog
These symptoms typically occur in phases, just like a regular migraine. Some people experience warning signs (called prodrome) hours or days before a silent migraine, such as mood changes, food cravings, or difficulty concentrating.
Causes and Triggers
Silent migraines are believed to be caused by temporary changes in brain activity and blood flow, similar to traditional migraines. While the exact cause is not fully understood, common triggers include:
- Stress and anxiety
- Hormonal changes (menstruation, pregnancy, menopause)
- Dehydration
- Sleep disturbances
- Certain foods(such as chocolate, caffeine, processed meats, and artificial sweeteners)
- Bright lights or loud noises
- Strong smells
- Weather changes
Keeping a migraine journal can help identify personal triggers and patterns.
Diagnosis
Because silent migraines do not cause head pain, they can be misdiagnosed. Doctors usually diagnose them by evaluating symptoms and ruling out other conditions. Tests such as MRI or CT scans may be ordered if a doctor suspects other neurological conditions, such as stroke or epilepsy.
Treatment and Management
There is no specific cure for silent migraines, but several approaches can help manage them:
Lifestyle Changes
- Identify and avoid triggers
- Stay hydrated and eat a balanced diet
- Maintain a regular sleep schedule
- Manage stress through relaxation techniques like yoga or meditation
Medications
- Over-the-counter pain relievers (for associated symptoms like nausea or dizziness)
- Prescription migraine medications (such as triptans or CGRP inhibitors)
- Preventive medications (such as beta-blockers or anti-seizure drugs)
When to Seek Medical Help
Seek immediate medical attention if symptoms include:
- Sudden difficulty speaking or understanding speech
- Weakness or numbness in one side of the body
- Severe dizziness or loss of coordination
These could be signs of a stroke, which needs urgent medical care.
Conclusion
Silent migraines can be confusing and unsettling, but they are a real and recognised type of migraine. Understanding their symptoms, triggers, and treatment options can help sufferers manage and reduce their frequency. If you experience silent migraines frequently, consulting a doctor can help develop a personalised treatment plan and rule out other serious conditions.
This blog is not written by a medical professional and should not be considered to be medical advice nor should replace medical advice from a trained professional. Please seek advice from a medical professional should you be suffering from migraines or any other medical conditions.