Silent migraines are a rare type of migraine that are experienced by 3 to 5 percent of the population. This unusual migraine is harder to diagnosis because people don’t experience all the normal migraine symptoms. However, that doesn’t mean that a silent migraine isn’t just as severe a problem. Silent migraines can be just as debilitating as migraines and should be taken seriously.
According to the International Headache Society’s Classification of Headache Disorders, silent migraines are migraines without pain. Often, these types of migraines are called acephalgic migraines, isolated visual migraines, migraines dissocié, or aura without headache. These all mean the same thing: a migraine without pain. I realize this seems impossible; however, it does happen. If this seems confusing, understanding the phases of a migraine will help you understand why a person can have a migraine without pain.
There are four specific phases of migraines that migraine sufferers generally experience. However, not all people who get migraines experience all four phases. Prodrome or the warning phase is the first phase a person can experience when they are getting a migraine. This phase can occur up to 24 hours before a migraine hits, and it is characterized by mental changes, such as irritability, and physical changes, like diarrhea. The next phase is the aura phase. This is the phase most generally associated with a silent migraine. Pain is the third phase, and it is the phase most people think of when they think of a migraine, but because a person doesn’t have to have all four phases, pain isn't a necessary component of a migraine. The last phase is resolution, in which a person can experience fatigue up to 24 hours after the migraine goes away.
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People with silent migraines experience all the usual migraine symptoms, except they don’t experience pain. Silent migraine sufferers can have nausea, vomiting, diarrhea, chills, fatigue, and irritability. However, one of the most common symptoms of a silent migraine is an aura. When an aura occurs, a person can see wavy lines, flashing lights, dots, or have tunnel vision. They can also have disruptions in hearing, numbness, difficulty saying or remembering words, or auditory hallucinations. An aura is different in each person, but visual disturbances are common. Auras can be very debilitating, which is why silent migraines are serious even though the person does not experience pain.
One cause of migraines is reduced blood flow to the cerebral cortex of the brain. Doctors used to think this was the only cause. However, now doctors also know that migraines can be caused by other problems such as a neurovascular event, which is characterized by nerve cells misfiring. This is especially relevant for people who get silent migraines because an aura is caused by an overstimulation of nerve cell activity followed by a decrease in activity. An imbalance of the neurotransmitter serotonin is another possible cause of migraines. Just like people experience migraines differently, the causes can also be different. Yet, when discussing silent migraines, neurovascular events are the most likely culprit if auras are involved.
Silent migraines may be an unusual type of migraine, but the treatment for them is similar to the treatment of traditional migraines. Often, medications are given to treat symptoms such as nausea or diarrhea. Traditional migraine medications like Maxalt are also used at times, but they are not as effective for silent migraines. Maxalt stimulates serotonin receptors in the brain, which causes blood vessels to narrow, returning blood flow to normal. However, it is more likely that a person with frequent silent migraines would be treated with anti-seizure medications that have been found helpful for migraines with auras. These medications are taken daily and used to prevent migraines from happening.
I am sure you know that there are certain things that can trigger a migraine. These things are exactly the same for people who have silent migraines. Common triggers for people who experience any type of migraine include ripened cheeses, chocolate, fermented foods, sour cream, nuts, and caffeine. Other migraine triggers include changes in barometric pressure, strong smells, and bright lights. Avoiding these common triggers can be very helpful, but it is also beneficial to keep a diary to see if there are other things that may trigger a migraine.
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Avoiding triggers is a great way to prevent a migraine without medication; however, there are certain vitamins that can also help. Magnesium and vitamin B2 are two vitamins that have been shown to reduce the frequency of migraine attacks. People who have migraines tend to have lower levels of magnesium, and studies have shown that those who take magnesium supplements reduced migraine frequency by 41.6%. Vitamin B2 has also been proven to be quite effective for some people. Studies indicate that people taking 400 milligrams of vitamin B2 reduced migraine frequency by 50%! If you suffer from any form of a migraine, magnesium and vitamin B2 supplements are certainly worth a try given their effectiveness.
Silent migraines are an unusual type of migraine but, as you can see, they share many similarities with more common types of migraines. The causes, treatments, and triggers of silent migraines are often the same. Yet, silent migraines are often difficult to diagnose because there is no pain involved. Do you know anyone who has been diagnosed with silent migraines?
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