My first known silent migraine episode

As a migraine advocate who is continually learning about this disease and its intricacies, I have long since heard of “silent migraine.”  I have wondered in passing if I’d ever had a silent migraine attack, but I never gave much thought to it.

Until earlier this month, that is.

Like many female migraine patients, my migraine attacks flare up before and during my period each month.  Like clockwork, here they come a couple of days before my flow—and they are sure to stick around and make their presence known all throughout my long period.  That is, until recently when I tried a new regimen (a prescription muscle relaxer + magnesium before bed each night—I have a different blog post about that in the works and will keep you updated!).

For the last few months, I can’t say my periods have been blissful, exactly (ha: won’t that be the day?!), but they have been much more tolerable because I have had significantly fewer days impacted by migraine. It feels somewhat miraculous compared to what I thought was a lifelong problem of having a multi-day migraine attack while dealing with the inconveniences of my menstrual cycle.  But lately things have been better during what was once seen as a doomed time, and I am grateful.

Toward the end of my most recent period, though, I started feeling really sick.  My stomach was jumpy and upset, and I was dizzy every time I stood.  In a word, I just felt BLAH.  Jim was concerned and asked if maybe I had a migraine coming on.  “I don’t think so,” I said, though his question immediately prompted me to analyze my own symptoms.  Well, I had had a rather stressful day, plus I was getting ready to be done with my period (toward the end of my cycle is when I tend to get a breakthrough migraine even in these miraculous times of new treatment).  I was extra sensitive to noise and light and had been kind of irritable earlier in the day. I was dizzy.

Whoa, I thought.

I think this is what I have heard of.  I think this is “silent migraine.”

Migraine.com describes silent migraine as “…a type of migraine that has many migraine symptoms, yet the head pain is absent. The terms silent migraine and acephalgic migraine refer to a migraine attack which skips the third phase of headache.” (See here for more detail.)  Silent migraine may also be called acephalgic migraine, migraine aura without headache, amigranous migraine, and/or migraine equivalent.

Thanks to my long history of migraine and tendency to learn as much as I can about this illness, I was able to recognize the migraine in disguise and have made a note to talk about it with my neurologist at my next appointment. (It’s always recommended that you talk to your doctor or migraine specialist any time your patterns change.) 

Have you ever had a silent migraine attack? How soon did it take you to realize what was happening?  Do you know anyone who only has migraine without headache? 

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

View Comments (27)
  • lizlight
    12 months ago

    This is my most common type of migraine but I feel like I’m just going down the list. I just finished my first 2 week episode of a cluster head ache not fun at all! I get so many different symptoms I don’t know where to start ,seems like a different thing every time. Everything seems to make it worse, booze, noise, heat, light, people, vibrations, movement. If I’m sad, stressed, ran too hard, if there is a storm coming in, if I’m about to be on my period. When I’m stressed I’m more likely to get a light sensitive head ache. I had to leave work (as a line cook) because I felt like I was a bell being rung by every noise and I got extreamly confused. Sometimes my neck feel crunchy and I get visual tracers or it seems like I’m seeing some things in still frame or it feels strange to turn my eyes. Because I don’t often have extreamly pain and I just feel sick, I feel guilty about wanting to see the Dr, because others have it so much worse and I feel like I should just work though it.

  • MissCottonHead
    3 years ago

    I’m really glad I found this site and this post particularly, thanks so much!
    I’ve been recently diagnosed with silent migraine, but didn’t get any information from the neurologist about all the symptoms it can cause (I didn’t get any information at all really…).
    Most are now explained by the silent migraine diagnosis, but one important one I can’t find in any symptom list of silent migraine. : waking up with a strong feverish feeling which sticks around all day without actually having a fever.
    Does anyone recognize this?
    Also I wonder if it’s possible to have an ongoing silent migraine attack: I’ve had all of the symptoms daily for the last two years.
    Since 6 weeks I use Butterbur, Magnesium spray, CoQ10 and vit. B2, which luckily have brought great relief, but I’m still not complaint free, especially the brain fog (hence my screen name..) is still quite debilitating.

  • The Migraine Girl moderator author
    3 years ago

    Hi, MissCottonHead:

    I’m sorry it took me a few months (!) to reply to this comment. I am so glad you found this post helpful. I hope that Migraine.com has been helpful as you learn about your migraine. From what I understand, it’s possible for you to have every single other sign of migraine that those with migraine headache suffer, so it stands to reason you might have daily silent migraine.

    I totally know what you mean about feeling like you have a fever–I was just talking about this yesterday with my husband. He’s also a migraineur and was sweating like crazy during his attack yesterday, but his temperature wasn’t high at all.

    Here’s some information on that feverish feeling: https://migraine.com/blog/sensation-of-heat-during-migraine-attack/

    And just in case you ever really do take your temperature and find you have a fever, you should be familiar with this article: https://migraine.com/migraine-symptoms/fever/

    I hope you’re feeling okay and that you’ve seen some improvements since starting on butterbur, magnesium spray, CoQ10, and B2. Keep us posted!

    -Janet G., The Migraine Girl

  • kaitjackson
    4 years ago

    I get these far more often than I used to – somehow we’ve struck a balance of meds for me that has reduced the “pain days” to 2-5 a month (down from almost daily) but I still have silent migraines at least once a week. I can’t focus my eyes, I can’t form complete sentences, I mix up letters when typing, my vertigo is awful to the point that I will forgo drinking anything to reduce trips to the bathroom. Sometimes I’ll be so sensitive to light and sound during these that I have to put in my noise-reducing earbuds (not playing anything, just for the silence) and wear my sunglasses indoors. I’m just thankful on these days to not have any pain, because when I have ALL those things plus pain I feel wretched, am cross with everyone, and am mostly useless at work and at home.

  • youkayn00b
    4 years ago

    i get something like these – specifically ophthalmic/ocular migraine along with vestibular symptoms. basically i have a migraine almost every day, and some days there is pain whereas other days there isn’t. the symptoms may vary quite widely. i am thankful for the days i don’t have pain, but the other symptoms can be quite debilitating sometimes

  • Christopher
    4 years ago

    Not sure if this is a silent migraine, but lately I have been waking with some of the after affects of a migraine. Nauseous and dizzy with the feeling that my brain is smacking into my skull at any and every angular move of my head. Really odd feeling and only a mild headache, at worst. Still trying to understand why it did not wake me.

  • kajsa
    4 years ago

    Christopher, that sounds like my husband’s experience with BPPV (benign paroxysmal positional vertigo).

  • Ohio Gal
    4 years ago

    Howdy migraine gang! I believe my doc calls these vestibular migraines. I really believe they are better than those with pain since at least it doesn’t feel like I have a knife in my temple 🙂
    You can start to feel “nuts” after a while when you are dizzy, thick headed, slow thinking, achy, and just not yourself. I have had life changing migraine surgery with Dr Bahman Guyaron from University Hospitals in Beachwood Ohio and it really gave me my life back. I still suffer from chronic migraine, but the worst symptoms are gone now as he burned out several nerve endings and cut some muscles. No more stroke like symptoms, slurred speech, memory loss, floating colored lights, nor loss of peripheral vision! I can at least function now with the reduced symptoms. Let me just say this to my fellow desperate migrainers- you are not crazy, you do not need anti-depressants, psychotherapy, shock treatment, divorce, or an exorcism! You are not a “diva” because you cannot go to certain places like candle stores, video game arcades, large warehouses with flickering fluorescents, or the latest action flick at the movie theatre! Your body is just very sensitive to your environment, so please be gentle on yourself. The medical community has come a looong way in migraine treatment lately. I am now exploring the connection between a misaligned jaw (since birth) and migraines. I will keep y’all posted. Have a blessed hopefully migraine free day!

  • The Migraine Girl moderator author
    4 years ago

    Hey Shonna,

    Thanks for your thoughtful response. I am no expert in vestibular migraine, but I believe that is a little different from silent migraine. You can read about vestibular migraine here: http://migraine.com/blog/vestibular-migraine-under-the-updated-migraine-classification-system/

    And “silent” migraine isn’t an official diagnosis recognized by the International Headache Society, though many doctors do tell their patients that that’s what they’re dealing with when you have other symptoms/phases of migraine but no pain. You can read more about silent migraine here: http://migraine.com/migraine-types/silent-migraine/

    Finally, I appreciate your telling us about your very successful surgery! I am so happy for you. I hope you continue to feel better and better.

    Take care,
    Janet G., “The Migraine Girl”

  • Adrienne
    4 years ago

    I am so enlightened by the term ” silent migraine”. This was an.. Ahh hah!! momenent while reading as you described the symptoms I’ve had for oh so many years. Never quite understood why I have those almost non-descript days of feeling not so good and never connecting this to my disease of migraine. I have various signs on a day to day basis. Even tried the Botox for migraines with some success but not nearly as much as hoped for. Have tried many many prescriptions that caused my body to yell out STOP putting this in me! Alternative medicine of various herbs, minerals & vitamin supplements. Gone to chiropractors.Also, been taking prescription muscle relaxers since 1982 (can help take the edge off the symptoms to a degree.) Now I’m wondering if acupuncture can help if anyone has had some relief with that??? I thought once thru menopause it would all just disappear. Not happening! But I must say that I am encouraged to know I’m not alone by joining all of you in discussions.

  • The Migraine Girl moderator author
    4 years ago

    One of my favorite things about writing for this site and then communicating with everyone in the comments, in the forums, and on the Facebook page is that we all feel less alone the more we share our stories and experiences. You are definitely not alone!

    I have tried acupuncture, but my foray into it was very brief, and the acupuncturist wanted to focus first on my stuffy sinuses before moving on to migraine-specific treatment. For whatever reason (I have no idea why now, but am guessing it was money-related), I stopped going. Here’s an article on acupuncture you may find helpful: http://migraine.com/complimentary-and-alternative-therapies/acupuncture/

    Thanks so much for your thoughtful comments. I hope you’re feeling well today.

    -Janet G., “The Migraine Girl”

  • Ron
    4 years ago

    About 95% of my migraines are silent. I experience dull headaches daily, rarely are they severe. My most troubling symptoms are constant dizziness, vertigo and feeling like I’m coming down with the flu. Because my migraines are silent it took two years and many doctors before I got a diagnosis of migraine associated vertigo.

  • Marthas
    4 years ago

    It’s appears that recently I am experiencing the silent migraine. I have felt dizzy and I get that tingling sensation in my scalpe yet the migraine pain remains absent. This will definitely be discussed with my neurologist at my next visit.

  • The Migraine Girl moderator author
    4 years ago

    Kudos to you for making a point of discussing this with your doctor. Let us know how it goes!

    Take care,
    Janet G., “The Migraine Girl”

  • TracyM09
    4 years ago

    Oh yeah, Silent Migraines are a thrill! You think you should be ok, because that piercing nasty pain isn’t present, however, you feel like a total mess. I’ve had several, and though the pain isn’t there the sensitivity to light, sound and smell is turned way up. I never was a menstrual Migraine person, so the start of my Migraines, both silent and full, was always a surprise! My first Silent Migraine was kind of scary, for sure. Be Well!

  • Mindy
    4 years ago

    Ha. So this would mean I have the symptoms that go along with my migraine-type headache, but no actual pain, right? That sounds remarkably pleasant, but I have not been rid of my headache for more than an hour or so for about 16 years :-\

  • Joanna
    4 years ago

    I have had silent migraine as well as more standard migraine with aura since childhood. It is chronic for me. I always had episodes of ringing in my ears, arms and legs going numb, periods where my vision would go dim in one eye, balance problems, etc. no one thought this was a big deal, including myself. Over a decade ago, I had a month-long migraine (with head pain), and even then no doctor made the connection between my migraines and these other symptoms. Following the birth of my children, in hindsight I realize I became chronic at this point. I frequently had crushing fatigue (even after my kids were sleeping through the night), all sorts of visual disruptions – scintillating scotoma, positive and negative sparkers, distortion in my peripheral vision, etc. Facial numbness started happening, torso numbness – really bad because if you can’t feel your bladder, you can imagine what happens, increase in speech problems, burning scalp, weakness in arms and legs, dizziness, tremors in my arms, and all the usual – sensitivity to light, etc. At this point my husband and I decided I should go to a private clinic as we weren’t getting anywhere with my GP (we’re in Canada). Even then the private clinic couldn’t put it together. Then I significantly worsened again – in hindsight I realize this is the point at which my nervous system became hypersensitized. All sorts of secondary symptoms rolled in – irregular heartbeat, sleep problems (later identified as alpha-EEG intrusion), frequent muscle twitches, etc. at this point the doctors around me sat up and took notice – first they thought TIA or a stroke, then they though MS, one doc was convinced it was a thyroid problem despite me never having any tests show there was anything wrong with my thyroid. Eventually I was diagnosed and put on preventatives, which have helped a lot, but I still have rough patches and realize I will have this for the rest of my life. Even now I field remarks from my neuro who specializes in migraine like “but a lot of your symptoms don’t really cause too many problems – going numb doesn’t stop you from doing anything…” To which I think “except that it’s a pronounced enough sensation that it wakes me from my sleep, repeatedly, and if my torso goes numb I would have to wear adult diapers to leave the house…” However poorly understood regular chronic migraine is, silent migraine is ten times more poorly understood.

  • The Migraine Girl moderator author
    4 years ago

    Thank you for your thoughtful response and for sharing your personal story, Joanna. I’m grateful you seem to be on the upswing at least a tiny bit, and I know you’ll keep doing whatever you can to feel as well as possible.

    I admit I rolled my eyes playfully when you mentioned your doctor saying, “…but a lot of your symptoms don’t really cause too many problems.” One of the hardest things to convey to people (including family members, friends, coworkers, and even migraine specialists) is how much migraine impacts every single facet of your life, and how your quality of life can suffer tremendously even if you aren’t having debilitating head pain.

    Take care,
    Janet G., “The Migraine Girl”

  • HJ
    4 years ago

    THATS what that was!!! I get these all the time, also accompanied by a swimmy, like, dipping out feeling. Almost like being on some sort of weird drug that’s supposed to make you dizzy and sick…

    THANK YOU!!!

  • Katiemcguire68
    4 years ago

    HJ, I love that you used the word swimmy!That is how I have been describing this feeling for 35 years and no one has ever had a clue what I was talking about! THANK YOU!!

  • aellis
    4 years ago

    Wow! Like some others have mentioned, I have them all the time and they have been occurring for years. Didn’t realize that is what they are. I have aura without migraine at least once or twice a week combined with other AIWL-esque symptoms.
    At work with a migraine hangover today. Yay….
    Thanks for sharing all that you do.

  • msruff
    4 years ago

    So, that’s what it’s called. I get them all the time, but I never associated them with a migraine since there was no pain.

  • zippy36
    4 years ago

    I had never heard of a silent migraine. One night at work I experienced blocked vision. I kept seeing a block of white light in place of part of my vision. I tried to stay calm and called my boss to please come to my section. (I want to add that the boss I have now is awesome about my migraine episodes and has bent over backwards to make sure I get through them while I am at work. I work at a job where I can not leave unless someone else is there to take my place.)He took me to a quiet place and sat and talked with me while the white light completely wiped out my vision. He was very concerned and wanted to call an ambulance. The funny thing was that besides my vision, I felt okay. I told him that I may be getting a migraine. I have had lights in my vision before but nothing like this!! I admit that while I tried to stay calm, I was also very frightened but asked him to just sit with me for a bit longer. Withing about 20 minutes my vision started to return. I felt a slight ache in my temples and took my medication. I never did get the migraine. Concerned I started to research on the web. I was new to this site and was surprised to see information about silent migraine. I am thankful for this site. It has been a treasure of information.

  • Meggietye
    4 years ago

    wow..so THAT is what is happening! I have had silent migraines for the last 5 yrs then again this summer for 3 months straight, minus the 2 days I actually got the head pain. I bought the paperback, “Migraine Brain” by Dr Carolyn Berstein, M.D ( 8.99 US and 11.99 Canadian)… BEST money I have spent in years, maybe ever. I have read it cover to cover, taken all the tests and am doing all her suggestions. Just this morning I staved off a migraine without usual suspect of drugs…I had coffee instead. I have just purchased more books to give out to migraine patient friends and family…no doctor appointment will give you what Dr Bernstein has put in these 519 pages. Everything is included..do yourself a favor and put your pennies away for this book. Migraine patients and partners/spouses/friends need this reading material..it will revolutionize your knowledge base and treatment plan.

    Cheers,

    Nancy

  • cynajen
    4 years ago

    Nancy, I completely agree! It’s an outstanding book. It’s helped me enormously in understanding my chronic migraines and even these sneaky silent migraines. It’s also been tremendously helpful in allowing my family to understand what I experience. A must have book for any Migraineur!

  • SamanthaAnn
    4 years ago

    I met with a new headache specialist last week because i was just not happy with the treatment my normal neurologist had me on. I thought the preventative medication I was taking was great because I didn’t have any pain and my migraines seemed to be reduced. I didn’t feel like myself and my head always felt like it was on the verge of something crazy. After meeting with the new doc and telling him what I was going through he pretty much told me that the preventative I was on was causing an almost constant migraine. I now understand that I had a 4 month long silent migraine. I’m so glad I was able to find relief. Good luck with your neurologist!

  • maxgordon
    4 years ago

    The timing on this couldn’t have been stranger. Like you, I had heard of but never thought much about silent migraines. But now, reading this, I know exactly what was going on with me just the day before (dizzy, nauseated, trouble talking, hypersensitive). I suspect it was a rebound migraine, as I was just tapering down from a multiple-day attack, and in that tricky period where I hate taking any medication but can’t quite get by with just environmental controls (lighting, ice packs, etc.).

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