Silent Migraines

Medically Reviewed by Melinda Ratini, MS, DO on April 17, 2024
3 min read

If you have a silent migraine, it means you get any of the typical migraine symptoms except for one: pain. Your doctor may suggest medications or devices that can treat the problem. You can also help yourself by avoiding your migraine triggers.

You can have symptoms that go along with any phase of a migraine, but without the classic pain around your temples.

During the phase that warns you a migraine is coming, called the prodrome phase, you could:

Next, the aura phase usually lasts about an hour. It's best known for its unusual visual symptoms, such as seeing:

  • Wavy or jagged lines
  • Flashing lights
  • Dots or spots in your vision
  • Blind spots
  • Tunnel vision

But it can also affect your other senses, movement, and speech. You may have:

  • Trouble hearing, or hear things that aren't there
  • Strange smells or tastes
  • Numbness, tingling, or a pins-and-needles feeling
  • Weakness
  • Trouble remembering or saying a word

Even though your head doesn't hurt, a silent migraine may affect your body in other ways:

  • Upset stomach or vomiting
  • Hot flashes and chills
  • Stuffy or runny nose
  • Dizziness or spinning (called vertigo)
  • Sore neck or jaw
  • Sensitivity to light, sounds, smells, touch, or motion
  • Confusion

Afterward, you may feel wiped out and have the blahs for as long as a day.

Not all migraine attacks follow the same pattern. Even for the same person, the symptoms can be unpredictable.

Researchers are now looking at aura and pain as two distinct things.

In the past, experts thought migraine was mainly a problem with blood flow in your brain. Now they believe the headaches involve the way nerve cells are firing in your brain and how that activity relates to the blood flow.

Aura appears to be a case of too much stimulation of the nerve cells and then a drop-off of activity in the brain. The decrease spreads across the top layer, or cortex, of your brain. It often travels from the visual part of the brain (occipital lobe) to the body sensation part of the brain (parietal lobe) to the hearing part of the brain (temporal lobe). This mirrors the visual, sensation, and hearing symptoms common to migraine.

Silent migraines can be set off by the same things that cause painful ones. What and how you eat are common triggers, such as:

  • Caffeine
  • Alcohol
  • Chocolate
  • Nuts
  • Pickled foods
  • Foods or drinks with the amino acid tyramine, such as red wine and aged cheese

It could be something happening around you:

  • Bright or flickering lights
  • Loud noise
  • Weather and extreme heat or cold

Changes in your hormone levels -- during menstruation, pregnancy, or menopause, or when taking birth control pills -- may affect women.

Your general well-being is also important.

  • Stress, either physical or emotional
  • Lack of sleep
  • Skipped meals

Headache experts say keeping a daily diary is an important step. Try to track everything you eat and drink, changes in your sleep or stress levels, and other possible triggers. Also, keep tabs on your symptoms and the times they begin and end. Your diary and your medical history will help your doctor figure out what's going on.

In rare cases, your symptoms could be a sign of a different, more-serious medical problem, such as a stroke or bleeding in the brain. To rule these out, your doctor may want to do more tests, such as a CT scan or MRI, or have you see a specialist called a neurologist for an exam.

More than 100 medications can treat migraine. Be prepared to try different drugs to find the right one for you. Tell your doctor about all prescription and over-the-counter medicines you take to avoid problems with how any of them work and side effects.

Once you figure out your triggers, try to stay away from them. If your symptoms are severe or regular, your doctor may suggest a medication or device to help prevent your migraine headaches.

Eat well, get plenty of rest, exercise most days, and find ways to manage your stress.