Silent migraine: What to know
The causes, risk factors, and treatments for all migraines are similar, regardless of whether or not they are silent migraines.
In this article, we take a closer look at the symptoms of silent migraines and discuss how to treat and prevent them.
Pain is a significant symptom of most types of migraine. Silent migraines do not cause pain, but they share the other typical symptoms of regular migraines.
These symptoms vary according to the phase of the migraine. The phases and their symptoms are as follows:
The prodrome phase
Phases of a silent migraine include the prodrome phase and the aura phase.
This phase occurs before the onset of a migraine and may begin a few days or just a few hours ahead of it. Symptoms can include:
- difficulty concentrating
- difficulty speaking and reading
- fatigue and yawning
- food cravings
- muscle stiffness
- sensitivity to light and sound
- sleep disturbances
- frequent urge to urinate
Most people experience the prodrome phase, but it may not occur before every migraine attack.
The aura phase
Only 20–25 percent of people with migraine experience aura. People with silent migraines have aura symptoms without a headache. Aura symptoms include:
- numbness and tingling in parts of the body
- temporary loss of sight
- visual disturbances, such as the appearance of patterns, flashing lights, or blind spots in front of the eyes
These symptoms develop gradually and can persist for up to an hour or more.
The headache phase
During the headache phase, people typically experience pain that can last from 4–72 hours. This is not the case for those with a silent migraine, who are likely to experience the following symptoms during this phase:
- anxiety or depressed mood
- inability to sleep
- nasal congestion
- neck pain and stiffness
- sensitivity to light, smell, and sound
The postdrome phase
Approximately 80 percent of people who have migraines will experience postdrome. It occurs at the end of the headache phase, which is why some people call it the "migraine hangover."
The postdrome can last for 24–48 hours and may cause the following symptoms:
- body aches
- difficulty concentrating
- euphoria or depression
Alcohol and caffeine can trigger a migraine attack.
The exact cause of migraines is unknown, but genetic and environmental factors are likely to play a role.
Migraines may occur due to abnormal brain activity that affects nerves and blood vessels. Changes in brain chemicals, such as serotonin, may also be a contributing factor.
Several factors can trigger a migraine attack, including:
- certain foods
- alcohol and caffeine
- changes in sleep habits
- changes in the weather or barometric pressure
- fluctuations in estrogen in females
- intense physical exertion
- sensory stimuli, such as bright lights, loud sounds, and strong smells
- use of some medications, such as oral contraceptives and vasodilators
The following factors increase the risk of silent and other types of migraine:
- Sex. Women are up to 3 times more likely to experience migraines than men, according to the World Health Organization (WHO). This is primarily due to fluctuations in female hormones. Migraine risk rises during pregnancy, menstruation, and menopause.
- Age. Migraine risk is highest in people aged 35–45. However, migraines can affect much younger or older people. Migraine attacks generally peak when people are in their 30s, and the severity and frequency of the attacks generally decrease with age.
- Family history. People with a close family member who experiences migraines are more likely to have them.
Types of migraine
A silent migraine is just one type of migraine. Other types include:
- Migraine without aura. This is when people do not experience the aura stage. Most migraines occur without aura.
- Migraine with aura. In this type of migraine, people get aura symptoms before the headache phase occurs.
- Basilar migraine. This form of migraine is rare and can be frightening. The symptoms may include double or blurred vision, loss of balance, fainting, and difficulty speaking.
- Hemiplegic migraine. During a hemiplegic migraine, a person will experience temporary numbness, weakness, or paralysis on one side of the body.
- Ophthalmoplegic migraine. This rare type of migraine causes weakness in one or more of the muscles that move the eye. It occurs most often in young people.
- Vestibular migraine. People having a vestibular migraine will experience vertigo that can last from a few minutes to a few hours.
A doctor can diagnose silent migraines based on a person's symptoms and medical history. They may also do a physical and neurological examination.
For severe or unusual symptoms, a doctor may order additional tests, such as:
Migraine treatments can reduce the frequency and severity of migraines. Treatment options include:
The main types of medicine for migraines are:
- Pain relievers: These may stop symptoms once they begin. Pain relievers for migraines are available over the counter (OTC) or by prescription.
- Preventive drugs: People can take these medications regularly to reduce the risk of developing a migraine. Doctors usually prescribe them for people who have recurrent, persistent, or severe migraines, or whose symptoms do not respond to regular pain relievers.
Lifestyle and home remedies
Getting enough sleep at night may help relieve symptoms.
Some people find relief from migraine symptoms using home remedies. These include:
- practicing relaxation techniques, such as progressive muscle relaxation, meditation, and yoga
- getting enough sleep each night
- resting in a dark, quiet room when symptoms start
- placing an ice pack on the back of the neck
- gently massaging painful areas of the scalp
- keeping a diary to help identify migraine triggers
Some people, especially those with chronic migraine pain, may benefit from alternative therapies.
Alternative therapies for migraines include:
- Acupuncture: According to a 2016 review, acupuncture may reduce the number of migraine attacks in people who experience several episodes a month.
- Biofeedback: A real-time assessment of biofeedback for migraines suggested that the treatment can improve symptoms, such as psychological stress, anxiety, depression, irritation, and headache-related disability. It may also reduce the duration of migraines and the number of days when the headache is intense.
- Massage therapy: Regular massage therapy can reduce stress and muscle tension, and it may reduce the frequency of migraines.
Management and prevention
Certain lifestyle changes may help reduce or prevent migraine symptoms. People can try:
- identifying triggers and avoiding them if possible
- practicing stress-relieving activities, such as meditation, creative therapies, mindfulness, and yoga
- exercising regularly but avoiding sudden and intense exercise, which may trigger a migraine
- going to bed and getting up at the same time each day
- establishing regular mealtimes
- avoiding caffeine and limiting alcohol intake
- quitting smoking
- reaching and maintaining a healthy body weight
People who experience migraines relating to hormonal fluctuations should speak to a doctor who may be able to help them reduce the effects of estrogen.
Some people may need to avoid medications that contain estrogen, which include many types of birth control pills.
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 a doctor for advice and treatment.