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Bouts of Nausea = Headacheless Migraine?

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.

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The Migraine.com team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.

Comments

  • Flapharder
    4 years ago

    Headacheless Migraine for me is: confusion, amnesia (after the fact) sometimes nausea, just a general feeling that the headache is coming. I was quite horrified a couple of weeks ago when I had an attack like this, and I was at work. I tried to write my surname on a document, and when I looked back at it the letters were all in the wrong place. It was like my brain and logic skills died! I drove home so scared that I was going to cause an accident, as I was clearly impaired. Biggest problem with these is that you can NOT treat them. Pain is treatable, but neurological disturbances are not. Of course by the time you get to a doctor, none of the weird stuff is presenting itself. I am surprised at how many neurologists have less insight and information about migraines than us as migraineurs have. As a side note, I found a fantastic book “The Migraine Brain” in Walgreens one night, and it really is super helpful….more so than my doctor in many ways. Sorry Doc.

  • Jill M.
    4 years ago

    I have this book as well. It is very well written and informative!

  • Ann
    4 years ago

    I have had migraines without pain since I was diagnosed with Hashimoto’s over 10 years ago. Prior to menopause, I suffered from hormonal migraines each and every month and they were painful. I can only wish for those days. I could take Anacin for 3 days each month and keep the pain at bay. I prefer the pain because I could dull it with Anacin and still drive, go to work and live my life those few days a month. Now I have to deal with the week after week of neurological disorders and abdominal migraines that I have been suffering from for these past 10 years. Ocular, abdominal, neurological—you name it–it’s my daily life. There’s nothing I can do for any of the above. Give me back my pain. Please…

  • stacysillen
    4 years ago

    This describes me; lots of muscle tightness in my neck and upper shoulders, auras, nausea without the relief of vomiting, sensitivity to sounds, smells and lights. I have found a great place for in-between botox appointments; it’s an Urgent Care with a Headache Clinic. There I can get a Nerve Block (basically they inject me in the back of my head with novacaine) and anti-nausea tablets that melt on my tongue, or pain shots. They let me rest in a reclining chair with dim lights and bring me ginger-ale, and saltine crackers. They send in an RX for a 5-day pack of steroids. All this, and still they ask me to rate my pain. I try to explain that it’s not a headache, doesn’t always feel like ‘pain’, but most of them don’t understand. So I just say a number that I think is about how whacked-out I am…

  • Dizzy1i
    4 years ago

    After reading endless articles on this site that discuss migraine mostly in terms of a headache perhaps with aura, this article is a breath of fresh air that might elevate discussions of migraine. I never get a headache; instead, the world spins. Run to the bathroom to vomit? First, tell me which way is up.

    I feel lucky because my drug regimen has kept my attacks suppressed, mostly. But when an attack hits, no oral or injectable rescue drug works. I am lucky because i do not present migraine symptoms that are the same as a left side stroke, as occurs for a friend.

    It is time to stop discussing migraine as a headache. Migraine and headache have different origin, as shown in functional MRI and PET images. Migraine impacts lives more profoundly. Let’s always call a migraine a migraine and never a “headache” or even “migraine headache” unless your distress, painless or not, can be cured with an aspirin.

  • Alexis14
    4 years ago

    Have never had N/V without a migraine with pain. The only time I had a migraine w/o pain was when I woke up one morning blind in one eye. My vision came back within a few minutes…after consulting with my internist and an ophthalmologist it was decided I had an “ocular migraine”. Made sense to me, as it was the eye on the same side as I always get my painful migraines. Only happened that one time, but no nausea involved

  • thisisendless
    4 years ago

    These are mostly the only kind I have. I have weird head pressure sometimes but it is never painful. I just get super dizzy and feel very “sick.” But I can’t precisely describe it. Nausea is almost always a factor. It is pretty much a daily occurrence if I am not currently on a med that is working. I am usually able to stay at work, I just feel awful.

  • Tracy Grant
    4 years ago

    I have had a few bouts of either waking with nausea, or upon lying down, feeling nauseous. It is usually something I have eaten, as i notice the nights i wake with nausea I have eaten a high fat dinner… so my liver/gall bladder isn’t happy – which is also consistent with migraines. ( our livers don’t like all the drugs we take). I have also had 3 aura migraines in my life, all without the pain of migraine. But mostly – when i feel nauseated, the body is fighting a migraine or in the process of alerting me one is on the way. My migraines have improved of late due to taking iron, which all migrainers need to look at as low iron causes the body to feel more pain. And B12 – which of course if you are low in it, makes you tired with can then trigger more migraines. Beware that most Drs will tell you that your iron levels are fine even if they are on the low side. Migrainers need to be above 50 for it to help pain wise, and restless legs wise, as i get that also. ( both neurological conditions). So hope this info might help someone as well, as it didn’t cure my migraines of course, but helped lessen the pain and duration.

  • Vanessa
    4 years ago

    I had heard of the headache pain-less migraine (all the symptoms of a migraine without the head pain) but never had one until last weekend. I had to switch migraine medicine because the insurance company wouldn’t pay for what works because it wasn’t on their “formulary”. So, I started taking a new medication. Little did I know that the drug I was taking lasts for 3 days — a beautiful drug that works so wonderfully (I miss it so much!) but the new drug doesn’t last. So, the second day was a rebound and I felt horrible and couldn’t understand why. I wasn’t used to this. So, three days, three pills later, when I was used to rationing pills, here I am thanking God that today I don’t have a migraine.

  • Jill M.
    4 years ago

    @Vanessa, Have you tried asking your doctor to contact your insurance company about covering the other med? Sometimes that will work if you can “prove” (through documentation) that the new med just doesn’t work.

  • Riza_Migraineur
    4 years ago

    I have been getting extremely sore neck and upper traps aches that can turn into migraines in the head that day or days later. After a few years now, I finally realized that my triptan medication (rizatriptan) works for the neck and traps and so must be early or just a migraine as is. Now I take the meds when this happens instead of trying to massage it out for hours and hours with no luck in the hopes of preventing a migraine. Duh!

  • Jill M.
    4 years ago

    I have also begun treating at the first signs. Works very well most of the time. In the times that it does progress to the next stages, I find it is much easier to treat as opposed to waiting. Unfortunately, migraine is a continual “trial and error” diagnosis as far as finding the right meds go.

  • JanetH
    4 years ago

    Several years ago, my mother complained to her internal medicine specialist of seeing what I know now is pretty classic aura. He asked her several questions, including, do you have head pain. The answer was no. She was told that it’s not uncommon for older people to experience a migraine with aura, but no pain. His only advice to her was don’t drive if it happens. She did not consult a headache specialist, probably because it didn’t happen often and she was fortunate enough to not have pain or nausea.

  • Kim Bourner
    4 years ago

    My nausea is a bit different, but also strong, and rarely do I actually vomit. However, I was blessed to have a doctor tell me within my first couple of years (it’s been over 20 now) that I could easily have migraine without head pain. I’d say at least 10% of mine are without head pain, maybe even as much as 20%. So glad to see it in writing here too!

  • Sheila K.
    4 years ago

    I was undiagnosed for 41 years, all because I suffer every symptom of migraine, but no headache. It is too chronic to be helped at this age and symptoms vary depending on the layered triggers. When I actively participated in Migraineur Misfits, I became concerned that many patients might not realize how often they have silent migraines. I am homeless now, because people do not understand this disease without headache and as you know, they commonly run from learning “what real help is”. I am constantly stuck, trying to help a person’s ego accept the facts of migraine, when they are offended that I took glass covered wall hangings down (after telling me to do what I need to), then help their ego accept that I have tried all the meds available for ongoing aura sensory attacks and that I don’t have a misdiagnosed condition. One symptom “headache” must be removed by the IHS in the naming of this disease. Calling it a headache disorder/primary headache is grossly abusing the process of awareness for everyone involved. So sorry, Kerrie, to read that you are getting more of the nausea symptom. I am so sorry you and so many of us suffer every day.

  • Beth
    4 years ago

    Inever thought about this!! My nausea has been hitting me in the morning. Like mild morning sickness. My Dr wants me to journal only the pain. I’m going to see him this week. I’m going to ask him about this!

  • Luna
    4 years ago

    Isn’t it fun. All these weird manifestations of migraine.

  • Luna
    4 years ago

    I really agree that migraine disorder should not have a headache as the primary or defining symptom. It is a whole body disorder which may include headache.

    When I have tried to remind my sister that she has migraines and some of her vague symptoms may just be that, her response is “I haven’t had a headache in 20 years”. Even though in 2013 she was diagnosed with “silent migraine”. She has had several surgeries since then and just does not remember. Or chooses not to and won’t educate herself on it. But really most of the info that I’ve found on silent migraine is pretty vague. And I can’t find any real detail about the way migraine affects the gut. Just that it can slow down the digestive process. And aura is mostly talked about as visual and only lasting 30 minutes soon followed by a full out attack (headache). My disorder doesn’t go this way. Must be something wrong with me. lol

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