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    What Are Silent Migraines?

    What Causes Silent Migraines?

    Researchers are now looking at migraine aura and pain as two distinct mechanisms. Doing so is leading to a better understanding of silent migraine.

    In the past, experts thought migraines were primarily a problem with blood flow in the brain. That is they thought of them as "vascular" events. They now believe aura is a "neurovascular" event. That means it involves the way nerve cells are firing in the brain and how nerve cell activity relates to the brain's blood flow. Aura appears to be a case of overstimulation and then depression of nerve cell activity in the brain.

    This pattern of reduced brain activity is called "cortical spreading depression." It literally spreads across the cortex (top layer) of the brain. When it does, it often travels from the visual part of the brain (occipital lobe) to the bodily sensation part of the brain (parietal lobe) to the hearing part of the brain (temporal lobe). This pattern mirrors the visual, sensation, and hearing symptoms common to migraine. The wave of depressed cortical activity has been confirmed by functional MRI, a high-tech way of mapping how the brain works.

    Migraine pain is thought to be partly caused by blood vessels in the brain dilating. It's thought that the swelling activates pain pathways in the nervous system.

    What Triggers Silent Migraines?

    Silent migraines can be set off by a wide array of triggers, including:

    • physical or emotional stress
    • lack of sleep
    • skipped meals
    • caffeine
    • alcohol
    • environmental stressors such as weather and extreme heat or cold
    • certain foods such as chocolate, nuts, and pickled foods
    • foods that contain the amino acid tyramine, including red wine and aged cheese
    • hormone changes in women, such as during menstruation, pregnancy, menopause, or when taking birth control pills
    • bright or flickering lights
    • loud noise

    How to Cope With a Silent Migraine

    Headache experts may not agree on everything. But they do agree that keeping a daily diary is a critical step in diagnosing and treating your symptoms. Here are tips for coping with your migraines

    1. Keep a daily diary of symptoms. Try to track all of your food and beverages, changes in your sleep or stress levels, and any other triggers. Also, keep track of your symptoms and the times they begin and end.
    2. Talk with your doctor. Based on your symptom diary and medical history, your doctor may be able to diagnose your silent migraines. In rare cases, the symptoms of a migraine are a sign of a different, more serious medical problem, such as a stroke or bleeding in the brain. To rule out these problems, your doctor may advise further testing, such as a CT scan or MRI, and a complete exam by a neurologist.
    3. Weigh the pros and cons of medications. There are more than 100 medications used to treat migraine, according to the Migraine Research Foundation. Be prepared to try different drugs to find the right one for you. Be sure to tell your doctor about all prescription and over-the-counter drugs you're taking to avoid problems with drug interactions.
    4. Practice prevention. Try avoiding your personal migraine triggers as much as possible. For severe or chronic symptoms, your doctor may prescribe a medication or device used to prevent migraines.
    5. Practice good self-care. Eating well, getting plenty of rest, exercising regularly, and learning stress-management techniques can do wonders to ease and prevent your migraine symptoms.

    WebMD Medical Reference

    Reviewed by Neil Lava, MD on February 14, 2015
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