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Silent Migraine Isn't So Silent After All

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“Shhh… keep it down; I have a silent migraine.” Yes, you read that right — a silent migraine. What in the world is a silent migraine?

Have you ever heard someone say they have a migraine, but they don’t have a headache? What? Yes, that was my reaction, too! Aren’t you suppose to have head pain when you have a migraine? According to my research, you don’t necessarily have to. You can have a migraine without a headache. Migraine without pain is another baffling phenomenon that many people are not familiar with or do not understand. If you haven’t had chronic migraine and have not experienced the frustration of having all the mysterious symptoms migraine can bring, perhaps you have not heard of silent migraine.

During one of my neurologist visits, I was reluctant to bring up what I was feeling lately. I did not want him to think I was losing my mind. I had the migraine aura, yet I didn’t feel pain, and I told him this. I waited for him to look at me and say, “That’s impossible!” but instead, he gave me a sympathetic look and said, “You are experiencing an acephalgic migraine, sometimes called ‘silent’ migraine.” A migraine without the headache! Isn’t migraine always associated with pain? I guess not. I left the clinic knowing that what I was experiencing was absolutely real.

I’ve learned from that visit that silent migraine could bring out some if not all migraine aura without the head pain. Though hard to comprehend, silent migraine sounded fascinating to me, so I tried to educate myself. Don’t let the name fool you. Silent migraine can still be debilitating. Migraine aura such as:

  • light sensitivity
  • vision loss
  • seeing zigzags or
  • squiggly lines
  • numbness
  • tingling
  • weakness
  • confusion
  • difficulty speaking
  • dizziness
  • diarrhea
  • vomiting
  • Abdominal pain (sometimes called stomach migraine — I think I should write about this, too! My daughter has experienced this) can still be present without the headache.

As you can see, despite not having any pain, these symptoms can be enough to put a halt to anyone’s life. I was diagnosed with hemiplegic migraine presenting additional symptoms on top of some mentioned above; they usually mimic stroke-like symptoms, then a massive headache would usually follow. However, there are days when I only experience an aura, but they are enough to bring my whole body down.

Because silent migraine is “silent,” taking the proper medication can be a little tricky. There were days when I didn’t know what I was feeling. All I knew was that I didn’t feel well; therefore, I didn’t know what medicine to take. Medication for regular migraine usually treats silent migraine, my neurologist told me, but this has been hit and miss for me. It has been challenging for me to catch silent migraine in an early phase. Often, I wouldn’t realize that I was having one until it’s too late. There are many causes for silent migraine, or what most of us call triggers. Below are common causes for migraine, even silent ones.

  • neck problems (number one for me!)
  • noises (this, too!)
  • bright lights (yep!)
  • fermented foods
  • caffeinated drinks (This is very inconsistent for me)
  • wine (aha!)
  • barometric changes (ugh!)
  • MSG (I think so…)
  • stress (definitely!)
  • hunger (yes!)
  • exercise ( sometimes)
  • pain or other illness
  • odors (yep!)
  • eye strain (phone!)
  • too much sleep (yes!)
  • too little sleep (What? — shaking my head)
  • hormonal changes (yes! Pregnancy, menstruation, peri-menopause — yikes!)
  • chocolate (My favorite.)

Did I comment on all of them? Oh well! By the way, it’s a great idea to have a migraine trigger diary.

I try to find ways to avoid all the triggers, but it is not easy. Sometimes, we are not in control of our environment. There are times when I am very religious at watching my triggers, but at times, I slip. Chocolate! Rocky Road ice cream is my one guilty pleasure. I would usually pay the price for my “oops” later, though.

If you hear someone say they have a silent migraine, no, they are not “crazy!” Know that even though it’s called silent migraine, it doesn’t mean no symptoms are present. Silent migraine manifests in different debilitating ways. Someone who experiences this mysterious phenomenon needs rest, just like those who are having migraine with pain.

If you experience a migraine aura without a headache? There’s a possibility you could be experiencing a silent migraine. Talk to your neurologist and see what treatment is best for you.

Please remember, just because one does not feel the pain doesn’t mean they are not struggling. Silent migraine is just as enervating as any migraine can be, so please be compassionate and understanding.

I guess silent migraine isn’t so silent after all.

Image via contributor

This story originally appeared on

Originally published: April 27, 2021
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