Table of ContentsView AllTable of ContentsSymptomsTypesCauses and Risk FactorsDiagnosisTreatmentFrequently Asked Questions
Table of ContentsView All
View All
Table of Contents
Symptoms
Types
Causes and Risk Factors
Diagnosis
Treatment
Frequently Asked Questions
Acephalgicmigraine, or “silent migraine,” is a form ofmigrainethat occurs without an actual headache. This type of migraine is more common in people over the age of 50 and can happen to people who have had migraines before as well as people who have never had migraines.This article will go over the phases of silent migraine symptoms, the causes, and the risk factors for this type of migraine, as well as how silent migraines are diagnosed and treated.Symptoms of a Silent MigraineSymptoms of silent migraines typically involve three offour migraine phases. A silent migraine goes through the prodrome, aura, and post-dome phases but skips the headache phase.The four phases of a typical migraine are:Prodromephase:Symptoms appear that are warning signs a migraine is coming onAuraphase:Visual disturbances some people have before a migraine attackHeadache phase:Pain from the headache starts (the hallmark symptom of most kinds of migraine). Silent migraines skip this phase.Post-drome phase:After the headache, the “hangover” feeling people may have when an attack is doneEllen Lindner / VerywellPeople with silent migraine usually do not have one-sided head pain and they are also less likely to have other classic migraine symptoms like sensitivity to light, sound, and odors at the height of their episodes.Even without a headache, silent migraines can disrupt a person’s daily activities. The classic “half-moon” visual disturbance (where there is vision loss in half of both eyes), changes in color perception, and other vision problems are common.2:055 Types of Migraine Auras Visualized and ExplainedHow Long Will It Last?A silent migraine can last from 15 to 30 minutes, and it is usually no longer than 60 minutes. It can come back or be a one-time event.Types of MigraineA silent migraine is just one type of migraine. The different types of migraines are usually described based on the symptoms they cause and where they’re felt:Migraine with and without aura. Some people get “warning signs” or symptoms before the pain of a migraine headache starts. Some people get migraines without an aura.Hemiplegicmigraine.This migraine causes symptoms that some people mistake for a stroke, like temporary weakness or even paralysis on one side of the body.Ophthalmoplegicmigraine.This migraine is not common but can cause vision problems like trouble moving the eyes.Vestibular migraine.This type of migraine causes people to feel very dizzy (vertigo) for a few minutes or even a few hours.Abdominal migraine.This type of migraine causes GI symptoms like stomach pain and nausea instead of a headache.Menstrual migraine.This type of migraine islinked to a person’s menstrual cycle.Basilarmigraine.This uncommon migraine can be very scary, as it causes intense symptoms like passing out (fainting), vision changes, and trouble talking.Atypical Migraine: What to KnowCauses and Risk Factors for Silent MigrainesAs with migraine disease in general, the exact causes of a silent migraine are not fully understood. However, there are a few possible risk factors:History of migraines.Silent migraines can happen in people who have had migraine symptoms before, but they can also develop “out of the blue” in people who have never had a migraine.Age.People of any age can get migraines and they tend to start in adolescence or young adulthood. Some studies suggest that people over age 50 are more likely to have symptoms of acephalgic migraine. When older people who have had migraines before get silent migraines, symptoms such asnausea, vomiting, and sensitivity to light and sound tend to diminish along with the headaches.Sex.Some research suggests that acephalgic migraines account for 3% of migraines in females and 1% in males.Genetics.Migraines often run in families. People who have family members who get migraines are often more likely to have some kind of migraine themselves.Thetriggersfor silent migraines are the same as those for other types of migraines and headaches and include:Certain foods (e.g., chocolate, artificial sweeteners) and drinks (e.g., caffeine, alcohol)Getting dehydrated and skipping mealsEnvironmental factors (e.g., lights, smells, sounds, weather changes)StressNot getting enough sleepHormonesCertain medications (including overusing medications that treat headaches)Diagnosing Silent MigrainesDiagnosing migraines without headaches can be tricky. A provider may need to use different tests to rule out other conditions. For example, they may do some blood work or use imaging tests (like an MRI or CT scan) to see inside the head or neck.Sometimes, a provider will want to do a more involved test (like a spinal tap) to rule out a serious condition like an infection. One of the exams a provider will do can test a person’s brain and nerve function (neurologicalexam).It’s possible for a person to be mistakenly diagnosed withepilepsybecause the symptoms they get during a migraine attack and the results of their neurological exam can be similar. Acephalgic migraines are also misdiagnosed astransient ischemic attacks(TIAs)orstrokes.Some specialists say that an acephalgic migraine should be considered a cause of an acute episodic neurologic disorder, whether it includes headache symptoms or not.Diagnosing MigrainesTreating Silent MigrainesTreatment of silent migraines depends on your symptoms.Prevention is usually the first place to start. It often includes many of the same things that are used for typical migraines with headaches, such as medications for certain health conditions (e.g., high blood pressure or seizures) or antidepressants. Learning your triggers and trying to avoid them is also key.There are some new treatments to prevent migraines with and without auras, including anti-CGRP (calcitonin gene-related peptide) medications like Zavzpret (zavegepant) and devices like Cefaly (a transcutaneous electrical nerve stimulation device). However, these have not been studied in people with acephalgic migraine.While you’re having an attack, your provider may recommend over-the-counter (OTC) and/or prescription treatments to help with your symptoms.SummaryA silent migraine is similar to other types of migraines but does not cause a headache. While they are different from other kinds of migraines, the diagnosis and treatment are similar. Your provider will want to rule out other causes for your symptoms before diagnosing you with silent migraines and starting treatment and migraine prevention.Medications Used to Treat MigrainesFrequently Asked QuestionsCommon types of food that may trigger a migraine include alcohol, caffeine, processed meat, organ meat, cheese, chocolate, peanuts, fruits like citrus or kiwi, and food with lots of MSG, such as fast food.These trigger foods are not universal. Some people may avoid different types of food than those listed here.Transient ischemic attack (TIA) is a short-term stroke that can cause dizziness, difficulty seeing and walking, trouble with balance, confusion, speech and speech recognition, and numbness or weakness on a single side of the body.The stroke ends after a few minutes, but its symptoms can last between one and 24 hours. Experiencing TIA should call for an immediate visit to the hospital.Yes, migraines with aura can be dangerous. Migraines are known to increase the risk of stroke as well as other cerebrovascular diseases, such ascarotid stenosisandaneurism.Although silent migraines do not involve aura, they can be potentially hazardous at a particular moment, such as while driving a vehicle or operating heavy machinery.
Acephalgicmigraine, or “silent migraine,” is a form ofmigrainethat occurs without an actual headache. This type of migraine is more common in people over the age of 50 and can happen to people who have had migraines before as well as people who have never had migraines.
This article will go over the phases of silent migraine symptoms, the causes, and the risk factors for this type of migraine, as well as how silent migraines are diagnosed and treated.
Symptoms of a Silent Migraine
Symptoms of silent migraines typically involve three offour migraine phases. A silent migraine goes through the prodrome, aura, and post-dome phases but skips the headache phase.
The four phases of a typical migraine are:
Ellen Lindner / Verywell
People with silent migraine usually do not have one-sided head pain and they are also less likely to have other classic migraine symptoms like sensitivity to light, sound, and odors at the height of their episodes.
Even without a headache, silent migraines can disrupt a person’s daily activities. The classic “half-moon” visual disturbance (where there is vision loss in half of both eyes), changes in color perception, and other vision problems are common.
2:055 Types of Migraine Auras Visualized and Explained
2:05
5 Types of Migraine Auras Visualized and Explained
How Long Will It Last?A silent migraine can last from 15 to 30 minutes, and it is usually no longer than 60 minutes. It can come back or be a one-time event.
How Long Will It Last?
A silent migraine can last from 15 to 30 minutes, and it is usually no longer than 60 minutes. It can come back or be a one-time event.
Types of Migraine
A silent migraine is just one type of migraine. The different types of migraines are usually described based on the symptoms they cause and where they’re felt:
Atypical Migraine: What to Know
Causes and Risk Factors for Silent Migraines
As with migraine disease in general, the exact causes of a silent migraine are not fully understood. However, there are a few possible risk factors:
Thetriggersfor silent migraines are the same as those for other types of migraines and headaches and include:
Diagnosing Silent Migraines
Diagnosing migraines without headaches can be tricky. A provider may need to use different tests to rule out other conditions. For example, they may do some blood work or use imaging tests (like an MRI or CT scan) to see inside the head or neck.
Sometimes, a provider will want to do a more involved test (like a spinal tap) to rule out a serious condition like an infection. One of the exams a provider will do can test a person’s brain and nerve function (neurologicalexam).
It’s possible for a person to be mistakenly diagnosed withepilepsybecause the symptoms they get during a migraine attack and the results of their neurological exam can be similar. Acephalgic migraines are also misdiagnosed astransient ischemic attacks(TIAs)orstrokes.
Some specialists say that an acephalgic migraine should be considered a cause of an acute episodic neurologic disorder, whether it includes headache symptoms or not.
Diagnosing Migraines
Treating Silent Migraines
Treatment of silent migraines depends on your symptoms.
Prevention is usually the first place to start. It often includes many of the same things that are used for typical migraines with headaches, such as medications for certain health conditions (e.g., high blood pressure or seizures) or antidepressants. Learning your triggers and trying to avoid them is also key.
There are some new treatments to prevent migraines with and without auras, including anti-CGRP (calcitonin gene-related peptide) medications like Zavzpret (zavegepant) and devices like Cefaly (a transcutaneous electrical nerve stimulation device). However, these have not been studied in people with acephalgic migraine.
While you’re having an attack, your provider may recommend over-the-counter (OTC) and/or prescription treatments to help with your symptoms.
Summary
A silent migraine is similar to other types of migraines but does not cause a headache. While they are different from other kinds of migraines, the diagnosis and treatment are similar. Your provider will want to rule out other causes for your symptoms before diagnosing you with silent migraines and starting treatment and migraine prevention.
Medications Used to Treat Migraines
Frequently Asked QuestionsCommon types of food that may trigger a migraine include alcohol, caffeine, processed meat, organ meat, cheese, chocolate, peanuts, fruits like citrus or kiwi, and food with lots of MSG, such as fast food.These trigger foods are not universal. Some people may avoid different types of food than those listed here.Transient ischemic attack (TIA) is a short-term stroke that can cause dizziness, difficulty seeing and walking, trouble with balance, confusion, speech and speech recognition, and numbness or weakness on a single side of the body.The stroke ends after a few minutes, but its symptoms can last between one and 24 hours. Experiencing TIA should call for an immediate visit to the hospital.Yes, migraines with aura can be dangerous. Migraines are known to increase the risk of stroke as well as other cerebrovascular diseases, such ascarotid stenosisandaneurism.Although silent migraines do not involve aura, they can be potentially hazardous at a particular moment, such as while driving a vehicle or operating heavy machinery.
Common types of food that may trigger a migraine include alcohol, caffeine, processed meat, organ meat, cheese, chocolate, peanuts, fruits like citrus or kiwi, and food with lots of MSG, such as fast food.These trigger foods are not universal. Some people may avoid different types of food than those listed here.
Common types of food that may trigger a migraine include alcohol, caffeine, processed meat, organ meat, cheese, chocolate, peanuts, fruits like citrus or kiwi, and food with lots of MSG, such as fast food.
These trigger foods are not universal. Some people may avoid different types of food than those listed here.
Transient ischemic attack (TIA) is a short-term stroke that can cause dizziness, difficulty seeing and walking, trouble with balance, confusion, speech and speech recognition, and numbness or weakness on a single side of the body.The stroke ends after a few minutes, but its symptoms can last between one and 24 hours. Experiencing TIA should call for an immediate visit to the hospital.
Transient ischemic attack (TIA) is a short-term stroke that can cause dizziness, difficulty seeing and walking, trouble with balance, confusion, speech and speech recognition, and numbness or weakness on a single side of the body.
The stroke ends after a few minutes, but its symptoms can last between one and 24 hours. Experiencing TIA should call for an immediate visit to the hospital.
Yes, migraines with aura can be dangerous. Migraines are known to increase the risk of stroke as well as other cerebrovascular diseases, such ascarotid stenosisandaneurism.Although silent migraines do not involve aura, they can be potentially hazardous at a particular moment, such as while driving a vehicle or operating heavy machinery.
Yes, migraines with aura can be dangerous. Migraines are known to increase the risk of stroke as well as other cerebrovascular diseases, such ascarotid stenosisandaneurism.
Although silent migraines do not involve aura, they can be potentially hazardous at a particular moment, such as while driving a vehicle or operating heavy machinery.
12 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.American Migraine Foundation.Aura without headache or silent migraine.He Y, Li Y, Nie Z.Typical aura without headache: a case report and review of the literature.J Med Case Rep. 2015;9:40. doi:10.1186/s13256-014-0510-7The Migraine Trust.Types of migraine.Starling AJ.Diagnosis and management of headache in older adults.Mayo Clin Proc. 2018;93(2):252-62. doi:10.1016/j.mayocp.2017.12.002Upper Cervical Chiropractic of New York.Silent migraines.MedlinePlus.Migraine.American Migraine Foundation.Top 10 migraine triggers.NYU Langone.Diagnosing migraine.Weatherall MW.The diagnosis and treatment of chronic migraine.Ther Adv Chronic Dis. 2015;6(3):115-23. doi:10.1177/2040622315579627MedlinePlus.Transient ischemic attack.Øie LR, Kurth T, Gulati S, Dodick DW.Migraine and risk of stroke.J Neurol Neurosurg Psychiatry. 2020;91(6):593-604. doi:10.1136/jnnp-2018-318254American Migraine Foundation.Understanding Migraine with Aura.
12 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.American Migraine Foundation.Aura without headache or silent migraine.He Y, Li Y, Nie Z.Typical aura without headache: a case report and review of the literature.J Med Case Rep. 2015;9:40. doi:10.1186/s13256-014-0510-7The Migraine Trust.Types of migraine.Starling AJ.Diagnosis and management of headache in older adults.Mayo Clin Proc. 2018;93(2):252-62. doi:10.1016/j.mayocp.2017.12.002Upper Cervical Chiropractic of New York.Silent migraines.MedlinePlus.Migraine.American Migraine Foundation.Top 10 migraine triggers.NYU Langone.Diagnosing migraine.Weatherall MW.The diagnosis and treatment of chronic migraine.Ther Adv Chronic Dis. 2015;6(3):115-23. doi:10.1177/2040622315579627MedlinePlus.Transient ischemic attack.Øie LR, Kurth T, Gulati S, Dodick DW.Migraine and risk of stroke.J Neurol Neurosurg Psychiatry. 2020;91(6):593-604. doi:10.1136/jnnp-2018-318254American Migraine Foundation.Understanding Migraine with Aura.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
American Migraine Foundation.Aura without headache or silent migraine.He Y, Li Y, Nie Z.Typical aura without headache: a case report and review of the literature.J Med Case Rep. 2015;9:40. doi:10.1186/s13256-014-0510-7The Migraine Trust.Types of migraine.Starling AJ.Diagnosis and management of headache in older adults.Mayo Clin Proc. 2018;93(2):252-62. doi:10.1016/j.mayocp.2017.12.002Upper Cervical Chiropractic of New York.Silent migraines.MedlinePlus.Migraine.American Migraine Foundation.Top 10 migraine triggers.NYU Langone.Diagnosing migraine.Weatherall MW.The diagnosis and treatment of chronic migraine.Ther Adv Chronic Dis. 2015;6(3):115-23. doi:10.1177/2040622315579627MedlinePlus.Transient ischemic attack.Øie LR, Kurth T, Gulati S, Dodick DW.Migraine and risk of stroke.J Neurol Neurosurg Psychiatry. 2020;91(6):593-604. doi:10.1136/jnnp-2018-318254American Migraine Foundation.Understanding Migraine with Aura.
American Migraine Foundation.Aura without headache or silent migraine.
He Y, Li Y, Nie Z.Typical aura without headache: a case report and review of the literature.J Med Case Rep. 2015;9:40. doi:10.1186/s13256-014-0510-7
The Migraine Trust.Types of migraine.
Starling AJ.Diagnosis and management of headache in older adults.Mayo Clin Proc. 2018;93(2):252-62. doi:10.1016/j.mayocp.2017.12.002
Upper Cervical Chiropractic of New York.Silent migraines.
MedlinePlus.Migraine.
American Migraine Foundation.Top 10 migraine triggers.
NYU Langone.Diagnosing migraine.
Weatherall MW.The diagnosis and treatment of chronic migraine.Ther Adv Chronic Dis. 2015;6(3):115-23. doi:10.1177/2040622315579627
MedlinePlus.Transient ischemic attack.
Øie LR, Kurth T, Gulati S, Dodick DW.Migraine and risk of stroke.J Neurol Neurosurg Psychiatry. 2020;91(6):593-604. doi:10.1136/jnnp-2018-318254
American Migraine Foundation.Understanding Migraine with Aura.
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