What is a silent migraine?
Not every migraine is obvious. In fact, there are some surprising signs of an impending attack. And while a “silent migraine” isn’t an official medical term, patients sometimes use it to describe when they get a migraine aura (more on that in a minute) but don’t suffer from the accompanying head pain, explains John Rothrock, MD, a professor of neurology at the George Washington University School of Medicine and Health Sciences.
It may also indicate a missing migraine
Because it’s not an official diagnosis, a silent migraine can have multiple meanings. Another possibility is when someone gets that “I’m going to get a migraine” feeling (called a prodrome), but the aura or headache never shows up, adds Dr. Rothrock. “That day you might feel foggy, your coordination may be off, or you may feel uneasy.”
Understanding a migraine aura
One-quarter of migraine sufferers experiences an aura—a visual, sensory, or speech disturbance—before their migraine. You may see spots, lights, or zigzags, feel numbness or tingling in one arm, or have trouble speaking, notes the American Migraine Foundation. About a half hour later, the traditional unilateral head pain known as a migraine typically hits.
The bright side: it’s usually temporary
It’s a relief to know that auras are only temporary and the symptoms disappear within an hour—often within 15 to 20 minutes. Rarely though, some people may suffer from continuous auras. That may mean you have them throughout the day or they stick around longer than the norm, explains University of Arizona neurology professor John Wall, MD.
Migraines don’t keep the status quo
One reason migraines can be so perplexing to treat is that they differ so much from patient to patient. And they can even evolve. “Migraines are all over the board. No two are alike, even within the same person; migraines change throughout their life,” says Dr. Rothrock.
The aftermath
Just because your migraine is over doesn’t mean you have total relief. Following a migraine, you may also have what are called postdrome symptoms. “The day after a migraine, while you may not have much of a headache, you may feel hungover, washed out, and still can’t think as sharp,” explains Dr. Rothrock. This phase, which doesn’t include a headache, may be another facet of a “silent migraine.”
How to treat a silent migraine
Ask yourself how often they appear and how much they affect your quality of life: “If they’re infrequent, short, and non-disabling, I wouldn’t treat the aura itself,” says Dr. Wall. If they are persistent, you may benefit from preventative migraine drugs, but they won’t help everyone, says Dr. Wall. He adds that in some instances, off-label use of anti-epileptic medications may work because they stabilize the function of brain cells.
Have a plan in place
The first time you have an aura can be frightening—you have no clue what’s going on. If you get auras with or without headaches or “have a feeling” one is coming on, you should have a treatment plan in place with your doctor, says Dr. Wall. Being ready with your medications (OTC or Rx’s) in the event head pain hits is the best be-ready strategy, he says. Check out these seven natural headache home remedies.
Skip the eye doctor
It would be understandable if you may make an appointment with your eye doctor if you see spots, flashes, or sparkles, says Dr. Wall. It feels like a visual problem. But in this case, your eye doctor won’t be of much help, he says. You need a headache specialist to step in. These are the surprising problems eye doctors can spot first.
Get the right care
Only half of migraine sufferers get an actual diagnosis, and only half of those are prescribed treatment by their physician, Dr. Wall points out. Your primary-care physician is a great person to start with, but you’ll probably need to see a headache specialist. “It’s a lot to ask of a PCP to care for a disorder that’s always changing and has so many manifestations,” says Dr. Rothrock. A headache clinic or a neurologist specializing in headache management can help. One resource is the National Headache Foundation, which lists providers who are members of the foundation. The American Migraine Foundation also has a search function to find a qualified headache specialist.
