What Is a Silent Migraine? Symptoms and 4 Ways to Feel Better

When you think of a migraine, you probably picture intense, throbbing head pain that makes it hard to function. But not all migraines come with that telltale ache. Some, known as silent migraines, present with a range of symptoms just not the pain.

A silent migraine, also called migraine aura without headache, can bring on visual disturbances, sensory changes, and even speech difficulties. Here’s how to spot a silent migraine and what you can do to feel better.

What Is a Silent Migraine?

A silent migraine involves the typical aura phase of a migraine but skips the headache phase altogether. According to Laura R. Natbony, MD, FAHS, founder and medical director of Integrative Headache Medicine of New York, this means you might experience:

• Visual changes: Flashing lights, spots, or vision loss

• Sensory disturbances: Numbness or tingling

• Speech difficulties: Trouble finding words or speaking clearly

• Motor changes: Weakness or dizziness

Silent migraines may be triggered by factors like stress, hormonal changes, bright lights, certain foods, and sleep disturbances, much like traditional migraines.

Common Symptoms of Silent Migraines

While the absence of pain sets silent migraines apart, they often come with other migraine-like symptoms:

• Aura: The most common sign, often involving visual changes such as spots, zigzag lines, or temporary vision loss.

• Speech and Language Issues: Difficulty finding words or slurred speech.

• Neurological Symptoms: Numbness, vertigo, or imbalance.

• Other Symptoms: Nausea, dizziness, and sensitivity to light or sound.

These symptoms can vary widely from person to person and may last from a few minutes to several days.

The 4 Phases of a Silent Migraine

Not everyone with a silent migraine will experience all four migraine phases, but here’s what they can look like:

1. Prodrome: The "warning" phase that may involve food cravings, mood changes, and fatigue a day or two before an episode.

2. Aura: Can last anywhere from 5 to 60 minutes, though in some cases, it might persist for days.

3. Headache: Typically skipped in silent migraines, but this is when pain would usually occur.

4. Postdrome: Often described as a "migraine hangover," with feelings of fatigue, irritability, and brain fog.

How to Treat a Silent Migraine

1. Magnesium Oxide Supplements

Magnesium plays a role in preventing the electrical activity that can lead to a migraine aura.

• What to Take: The American Migraine Foundation recommends 400 to 600 mg of magnesium oxide daily.

• Why It Works: Magnesium helps reduce cortical spreading depression, which is thought to trigger migraine auras.

Pro Tip: It may take up to three months of consistent use to see results, so patience is key.

2. Preventive Medications

If silent migraines are frequent or disabling, your doctor may prescribe preventive medications such as:

• Lamotrigine: An anti-seizure medication that reduces brain neuron excitability.

• CGRP Inhibitors: These newer medications block a protein involved in migraines and can reduce frequency and severity.

While lamotrigine is taken orally, many CGRP inhibitors are available in injectable form, though some are also taken by mouth.

3. Lifestyle Changes

Maintaining healthy habits can help reduce the risk of a silent migraine:

• Prioritize Sleep: Aim for 7-9 hours of quality rest each night.

• Manage Stress: Try relaxation techniques like meditation, deep breathing, or yoga.

• Exercise Regularly: But avoid overexertion, which can be a trigger.

• Avoid Triggers: These might include certain foods (e.g., aged cheese, processed meats), strong smells, or bright lights.

4. Try an sTMS Device

One treatment specifically designed for silent migraines is the SAVI Dual by eNeura, an sTMS (transcranial magnetic stimulator) device.

• How It Works: The device sends magnetic pulses to the head and neck area when placed on the back of the head for a few seconds.

• The Benefits: It can both prevent and treat a migraine aura and is a good option for those who prefer non-drug treatments.

When to See a Doctor

If you experience new or worsening symptoms, it’s important to consult a healthcare provider.

• Red Flags: Auras that last longer than an hour, or neurological symptoms that are persistent or unusual, should be evaluated by a doctor, says Dr. Natbony.

• Get a Diagnosis: A healthcare professional can differentiate between silent migraines and other potential conditions, like strokes or seizures, which can present similarly.

The Bottom Line

Silent migraines may not cause pain, but they can still impact your quality of life. With the right combination of supplements, medications, and lifestyle adjustments, you can reduce the frequency and severity of episodes.

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