Chapter 1, Episode 4: What is Silent Migraine?


This content has been medically reviewed by Dr. Shivang Joshi.

Is it possible to have a migraine attack without a headache?

The answer is yes! Silent migraine, also referred to as migraine without headache, is a migraine attack with an aura that occurs without the headache. 

Silent migraine attacks are rare, accounting for 3% of migraine attacks in women and 1% in men.

An aura is a temporary sensory disturbance before or during an attack. An aura may include visual disturbances such as zig zag lines or flashing colors. A sensory aura may include a tingly sensation that begins in the arm and moves up toward the face. Other auras include confused thinking, the illusion of smells that aren’t there or slurred speech.

Other common symptoms that people experience are nausea, visual disturbances and the desire to lay down. The symptoms usually develop gradually over 5 to 20 minutes and typically last for less than 60 minutes.

Stroke, epilepsy and inflammatory cerebrovascular disease must be excluded prior to a diagnosis of silent migraine.

It is important to schedule an appointment with your doctor if you suspect you may have this type of migraine disease. 

Other disorders can be ruled out with diagnostic tests such as a thorough neurological examination, eye examinations and neuro-imaging such as a brain MRI. Diagnostic tests may vary based on the patient and presenting symptoms. 

Triggers are the same as those for classic migraine. They can include: caffeine, changes in weather, stress, lack of sleep, hormonal changes, food additives and alcohol.

Abortive treatment for silent migraine is the same as typical migraine such as anti-inflammatory drugs, anti-nausea medications, triptans and gepants. Treatment could also include preventative medications such as antidepressants, anticonvulsants, CGRP monoclonal antibodies, and vitamins like riboflavin and magnesium.

This video is sponsored in part by Amgen, AbbVie, Lilly, Lundbeck, and Impel Pharmaceuticals.



*The contents of this video are intended for general informational purposes only and does not constitute professional medical advice, diagnosis, or treatment. Always seek the advice of a physician or other qualified health provider with any questions you may have regarding a medical condition. AMD does not recommend or endorse any treatment, products, or procedures mentioned. Reliance on any information provided by this content is solely at your own risk.