Bouts of Nausea = Headacheless Migraine?
I woke to find myself mid-stride, dashing to the bathroom. I felt perfectly fine when I got into bed, while I was reading, and even when I settled in to sleep. Then a wave of nausea so strong hit that it sent me running before I even knew I was awake. That’s despite having only vomited twice in the last 10 years, even with severe nausea many of those years. In that moment, my instinct was in charge and getting to the bathroom felt like the right thing to do.
Scenarios like this or getting severely nauseated right before I drift off to sleep have begun to happen regularly. When I finally thought to mention these episodes to my headache specialist, he told me they’re probably headacheless migraine attacks. I have chronic migraine, my migraine attacks have changed considerably in the last 18 months, and I write about migraine for a living. I regularly tell people that migraine attacks don’t always include head pain. I figured the nausea was migraine-related, most of my health issues are, but it never once occurred to me that these bouts could be their own migraine attacks.
One of my migraine superpowers is that I rarely vomit. Another is that I can usually sleep (albeit fitfully and with nightmares) when I have a migraine at night. When I get these bouts of nausea, I take 4 mg or 8 mg of dissolvable ondansetron (Zofran) and am back to sleep in 15 minutes. I have no idea what my body feels like after I take the meds. Is my sleep disturbed on those nights? Do I have more bad dreams? Is this the reason I wake up feeling like I have a migraine hangover even when I don’t think I’ve had a migraine? I don’t know; I hadn’t thought to pay attention. I’m betting “yes” is the answer to all those questions.
I’m paying attention now. And am wondering if I’ve been having 10 more migraine attacks per month than I thought I was.
Note: Headacheless migraine attacks are also called silent or acephalgic. They are not a separate type of migraine, but are just different symptoms of whatever form of migraine you have. Headacheless migraine attacks are not the same as abdominal migraine, which also include stomach pain. Learn more: headacheless/silent/acephalgic migraine attacks and abdominal migraine
If you're having similar bouts of nausea, please mention it to your doctor. It's important to confirm whether migraine is the culprit or if you have a separate gastrointestinal issue.
How much has your migraine disease changed or evolved over time?