Silent Migraine: Symptoms and Treatment

Medically Reviewed by Zilpah Sheikh, MD on July 10, 2024
Written by Stephanie Watson
6 min read

A migraine is a throbbing headache that comes with a collection of sensory symptoms like vision changes, which is called aura. Silent migraine is a migraine without the headache. It causes aura without the throbbing pain of a typical migraine. 

Even without the headache, silent migraine symptoms can be severe enough to impact your daily life. Your doctor may suggest medications or devices to treat the problem. You can also prevent these headaches by avoiding your migraine triggers.

Just like regular migraine headaches, silent migraine comes in phases. You can have symptoms that go along with any phase of a migraine, but without the classic pain around your temples.

Prodrome phase

This phase warns you that a migraine is coming. The prodrome phase starts up to 24 hours before the silent migraine, with symptoms like these:

  • Crankiness
  • Hyperactivity
  • Food cravings
  • Tiredness and yawning
  • Trouble sleeping
  • Sensitivity to light and sound
  • Stiffness, especially in your neck
  • A hard time concentrating, talking, or reading
  • A need to pee more often
  • Constipation or diarrhea

Aura phase

Next, the aura phase lasts up to 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

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

  • Trouble hearing or ringing in your ears
  • Trouble speaking, forgetting or slurring your words, or mumbling when you try to talk
  • Strange smells or tastes
  • Numbness, tingling, or a pins-and-needles feeling
  • Weakness

Other physical signs of silent migraine

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

  • Upset stomach or vomiting
  • Chills
  • Stuffy or runny nose
  • Dizziness 
  • Sensitivity to light, sounds, smells, touch, or motion
  • Confusion

Afterward, you may feel wiped out and achy, almost like you’re hungover, for up to a couple of days.

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

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 the brain. Now they believe these headaches involve the way nerve cells fire in the brain and how that activity relates to 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.

Can weather cause silent migraine?

Some people with migraine are sensitive to changes in the weather. Possible weather-related triggers include: 

  • Bright sunlight
  • High humidity
  • Shifts from hot to cold weather (and vice versa)
  • Dry air
  • Storms 
  • Changes in barometric pressure

Changes in the weather might cause migraines or make one worse by altering levels of brain chemicals like serotonin.

The same triggers that cause painful migraine can also set off silent migraine. Foods and drinks such as these are common causes:

  • Foods or drinks that contain caffeine
  • Alcohol
  • Chocolate
  • Nuts
  • Pickled foods
  • Foods or drinks that contain the amino acid tyramine, such as red wine and aged cheese
  • Artificial sweeteners like aspartame

The trigger could also be something happening around you:

  • Bright or flickering lights
  • Loud noise
  • Weather changes like extreme heat or cold
  • Changing hormone levels in women and people assigned female at birth (AFAB) during menstruation, pregnancy, or menopause, or while taking birth control pills 
  • Taking headache medicine too often

These general health issues can also lead to migraine:

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

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.

Treatment starts by figuring out what triggers your migraine. Your doctor might suggest that you keep a headache diary, writing down what you ate or did before your migraine started. Then you can try to avoid your triggers.

Medicines are available that prevent and treat migraine. Preventive medicines are for people who get frequent migraine. They include:

  • Blood pressure-lowering drugs, including beta-blockers like metoprolol (Lopressor) and propranolol (Inderal), and calcium channel blockers such as verapamil (Verelan)
  • Tricyclic antidepressants like amitriptyline 
  • Calcitonin gene-related peptides (CGRP) monoclonal antibodies like eptinezumab-jjmr (Vyepti), erenumab-aooe (Aimovig), fremanezumab-vfrm (Ajovy), and galcanezumab-gnlm (Emgality)
  • Gepants like atogepant (Qulipta) and rimegepant (Nurtec ODT)
  • Anti-seizure drugs such as topiramate (Topamax) and valproate
  • OnabotulinumtoxinA (Botox) shots

These medicines treat migraine once it starts:

  • Triptans such as rizatriptan (Maxalt) and sumatriptan (Imitrex)
  • Dihydroergotamine (Migranal)
  • Lasmiditan (Reyvow)
  • Gepants like rimegepant (Nurtec ODT), ubrogepant (Ubrelvy), and zavegepant nasal spray (Zavzpret)
  • Anti-nausea medicines

You may need to try different migraine medicines to find the right one for you. Also aim to eat well, get plenty of rest, exercise on most days, and find ways to manage your stress.

Silent migraine is a condition that causes vision changes and other sensory symptoms, without the headache pain of a typical migraine. The same things that trigger migraine headaches also cause silent migraines, including weather changes, caffeine, and bright lights. Managing silent migraine starts by learning your triggers and avoiding them. Several medications can prevent and treat this condition. 

What is a silent migraine like?

A silent migraine involves sensory symptoms, like flashing lights or dizziness, without a headache.

Can dehydration cause silent migraine?

The same triggers cause silent migraine and migraine headache. Dehydration can cause a migraine, which is why it’s important to stay hydrated by drinking extra fluid.

What is the difference between vestibular migraine and silent migraine?

Vestibular migraine is a type of migraine that causes dizziness. Unlike silent migraine, vestibular migraine is a genetic disorder that runs in families, and it does cause a throbbing headache.

What is the difference between silent migraine and complex migraine?

A complex migraine is a throbbing headache plus symptoms like nausea, light and sound sensitivity, numbness, weakness, and trouble speaking. Another name for complex migraine is migraine with aura.

Is aura without migraine dangerous?

A silent migraine can feel scary when you’re having one. But it’s not dangerous or life-threatening.

What is migraine without aura?

Migraine without aura is a throbbing headache that comes on without warning signs like flashing lights or other sensory changes. It’s the most common type of migraine.