Posted by: courtneygrapperhaus | April 28, 2015

What is an “Acephalgic” or “Silent” Migraine?


Recently we received a question from one of our readers about silent migraines:

I was wondering if in one of your blogs you could discuss and explain silent migraines.  A month or so ago for the first time ever I started seeing zigzag lines in one eye.  It scared me since I never had this happen before.  Thought maybe I was having a mini stroke or something.  I call my doctor and the nurse said it sounded like a silent migraine.

There are 4 phases to a migraine:  Prodrome, Aura, Headache, and Postdrome. People typically associate migraines with the “headache” phase. However, some people suffer from “silent” or “acephalgic” migraines, those in which the person does not experience head pain, but does have the other 3 phases of a migraine. Any type of migraine can be silent.

While each type of migraine is different, some shared symptoms exist. During the prodrome phase, mental and physical changes occur such as irritability, confusion, depression, thirst and fatigue. Light and sound sensitivities are also characteristic of the prodrome phase. Aura is a change in one’s perception. During this phase, the migraine sufferer might begin to see wavy or jagged lines, dots in his or her vision, tunnel vision, and flashing lights. They may also experience a disruption to their sense of hearing, smell, and/or taste. In the postdrome phase irritability, confusion and fatigue are common.

Silent migraines have several possible triggers, many of which are triggers for other headaches as well. These triggers include poor nutrition, lack of sleep, noise, hormones, and stress.  According to Wikipedia, “Acephalgic migraines typically do not persist more than a few hours and may last for as little as 15 seconds. On rare occasions, they may continue for up to two days.”

WebMD offers the following tips to cope with 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.

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