Quiet Migraine: Symptoms, Causes, Diagnosis, Treatment


Acehalgic migraine or "silent migraine" is a form of migraine that occurs without an actual headache.


There are four phases of a migraine attack . Although a headless migraine may progress through a prodromal phase (when symptoms warn of an impending attack), an aura phase (visual disturbances that precede an episode), and a postdromal (or post-head) phase, it skips the headache, which is considered the hallmark of all other types of migraine.

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Because of this, people with silent migraines generally do not have a one-sided headache like other migraines. They are also less likely to experience symptoms such as sensitivity to light, sound, and smells in the midst of seizures.

Visualization and explanation of 5 types of migraine auras

Even in the absence of a headache, a silent migraine can greatly interfere with daily activities. Classic crescent-shaped vision impairment (loss of vision in the middle of both eyes), changes in color perception, and other vision problems are also common.

A silent migraine can last 15 to 30 minutes, but usually no longer than 60 minutes. It can be repeated or manifest as a single event .


As with migraines in general, the exact causes of silent migraines are not fully understood. Silent migraine triggers are the same ones that trigger other types of headaches. These may include, but are not limited to, skipping meals, insufficient sleep, certain foods, or types of light, and stress.

People over the age of 50 are more likely to have acetalgic migraine symptoms. They can occur in people who have previously suffered from total migraine symptoms or develop unexpectedly .

When they occur in older adults who have previously had migraines, symptoms such as nausea , vomiting, and sensitivity to light and sound tend to decrease along with headaches.

According to a 2015 study published in the Journal of Medical Case Reports , acetalgic migraines account for 3% of migraines in women and 1% in men .


It can be especially difficult for a healthcare professional to diagnose a migraine in the absence of a headache. In some cases, people with epilepsy have been misdiagnosed because of the neurological symptoms present in seizures. It is also possible to misdiagnose acetalgic migraine as a transient ischemic attack (TIA) or stroke .

Experts say that acetalgic migraine should be considered the cause of any episodic acute neurological disorder, whether or not it includes headache symptoms.

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Treatment for a silent migraine includes prophylactic treatments that are commonly used for typical migraines, such as medications to treat high blood pressure, antidepressants, and anticonvulsants.

New treatments for migraine with and without aura, such as drugs against CGRP (a peptide linked to the calcitonin gene) and new devices such as Cefaly (a device for transcutaneous electrical nerve stimulation) have not been studied in people with acetalgic migraine. but it can potentially be beneficial.

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If you consistently experience mild migraine symptoms, see your doctor. Depending on the circumstances, your healthcare provider may want to run tests to rule out more serious conditions, such as TIAs or seizures . If you have been diagnosed with a silent migraine, it may be helpful to test whether any of the traditional migraine triggers are causing the symptoms.

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