Migraine Aura Without Pain (Silent Migraine)

Reviewed by: HU Medical Review Board | Last reviewed: October 2020

The term “migraine” makes most people think of excruciating, debilitating head pain – and most migraine attacks do come with severe head pain. However, some people have migraine aura without pain. These episodes are still considered migraine attacks.

Migraine aura without pain is also known as silent migraine, typical aura without headache, and acephalgic migraine.

What is migraine aura without pain?

Migraine aura without pain includes changes in vision or changes in the other senses and speech but no head pain. Symptoms gradually build over 5 to 20 minutes and then go away after about 1 hour. The lack of head pain sets it apart from other types of migraine with aura. Also, no other disorder can be found to be blamed for the symptoms.1

Who gets aura without head pain?

Migraine aura without pain or silent migraine is fairly unusual. Only 4 out of every 100 people who get migraines have aura without pain and no other kind of migraine. However, 40 percent of people who have migraine with aura will have only aura symptoms and no pain at some point in their life.2

Migraine aura without pain is more common in women than men and tends to begin later in life. When it begins after age 60 it is called late-onset migraine accompaniment.2

Visual symptoms

The most common visual symptoms of migraine aura without headache, or silent migraine, include:2

  • Seeing flashes, or flickering or shimmering light
  • Seeing zigzag lines, waves, spots, stars, halos, circles, or other shapes
  • Blurry or cloudy vision
  • Loss of vision or blind spots
  • Double vision
  • Dilated pupils

Sensory symptoms

Changes in vision are the most common symptoms of silent migraine. However, changes in other senses happen too. The most common sensory symptoms of migraine aura without head pain include:2

  • Tingling or numbness that moves from 1 part of the body to another
  • Odd or prickly feelings, or numbness, in the hand, arm, face, or tongue
  • Odd feelings in the whole body
  • Vertigo
  • Amnesia or confusion
  • Trouble speaking
  • Hiccups
  • Loss of hearing
  • Droopy eyelid
  • Fainting

Is it hard to diagnose?

Migraine aura without pain can be hard to diagnose. It can be confused with stroke or seizures. Your doctor will have to rule out other, more common, health conditions before diagnosing you with migraine aura without pain. A migraine diary is an important tool in helping your doctor accurately diagnose silent migraine.1,,2

How is it treated?

It can be hard to treat migraine aura without pain. Symptoms often go away faster than drugs, such as triptans and NSAIDs, work. However, some people find that migraine symptoms like nausea and sensitivity to light get better with treatment.

There are no FDA-approved drugs specifically for migraine aura with pain or silent migraine. Some small studies have tested the use of magnesium, aspirin, lamotrigine (Lamictal), and ketamine.

What does migraine aura without pain feel like?

Migraine.com advocates often write about their experiences with migraine. In this video, A Peek into the Unique World of Migraine, 1 advocate talks about her migraine aura symptoms and another describes what it is like to speak “gobblygook” during a migraine attack.

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