What is a migraine? Why migraine happens. Who gets migraines? Treating migraines.

Silent Migraine

Inaccurate Terms

There's any number of layman's terms out there for the various types of migraines, but while the public likes to use these descriptive terms, they aren't accurate when used as labels for diagnosis since the terms describe symptoms rather than conditions. The terms can lead to some confusion when a patient tells the doctor he has this or that type of migraine. That's exactly what happens when a patient tells the doctors he's got a "silent migraine."

A "silent" or acephalgic migraine is a migraine attack without headache. This type of migraine has collected many descriptive names such as: eye migraine, migraine aura without headache, migraine equivalent, ocular migraine, painless migraine, sans migraine, and visual migraine.  

Any kind of migraine can be acephalgic. Migraine attacks have four phases:

Prodrome- In 30-40% of migraine sufferers: food cravings, constipation or diarrhea, mood changes, muscle and neck stiffness, fatigue, increased urination.

Aura- In 20% of migraine sufferers: visual disturbances, olfactory or auditory hallucinations, tingling or numbness of the face or extremities on the same side where the headache develops, speech difficulties, confusion, vertigo, partial paralysis, decrease in or loss of hearing, reduced tactile sensitivity or hypersensitivity to feel and touch.

Headache- Early morning pain may wake you up and can last from one to 72 hours. When pain lasts longer than 72 hours, this is called status migrainosus and requires medical attention. Physical activity may worsen the pain. Pain characteristics: one-sided pain, sensitivity to light or sound, nausea and/or vomiting, diarrhea or constipation, stuffy or runny nose, depression, intense anxiety, hot flashes and chills, dizziness, confusion, dehydration or fluid retention.

Postdrome-Drained feeling post-headache lasts hours or even days: Depression, euphoria, fatigue, poor concentration, poor comprehension, lowered intelligence. There may be abnormal cerebral blood flow and EEG readings for up to 24 hours after a headache.

Skip the Headache

A migraine sufferer or migraineur may or may not experience all of these four phases. And while a migraineur may experience 3 out of 4 phases with one migraine, he may suffer from 2 or 4 phases the next time. In an acephalgic migraine, the sufferer skips the headache phase. Put in these simple terms, it's easy to see how any migraine can be a "silent" one.

Once we learn more about our migraine symptoms, we can understand better how to avoid the headache phase; the most debilitating aspect of migraine headache. Even in a migraine attack that comes with no pain, medication can be helpful, though, since medication can prevent or relieve other migraine symptoms.