A headache without the ache? How can that be?
I just came across this article that explains how it is possible to have a migraine without the pain. I had no idea. I had an MRI done recently to try to get to the root of my issues that have been occurring lately. My doctor ordered the test on the chance that I might have a benign tumor. Well, I am happy to report that there is no tumor and no signs of a stroke. However, she is referring me to a neurologist to try to determine whether I am dealing with MS (Multiple Sclerosis) or Silent Migraines. Based on my research (and no, I am not a doctor), I have symptoms that could be explained by either or both issues.
What Is a Silent Migraine?
Migraine is a neurological disorder that generally includes headaches. But it doesn’t always. Some people have “silent migraine” — a migraine without the symptom of headache pain.
To understand silent migraine, it helps to know the four distinct phases of migraines.
- Prodrome. The “prodrome” phase warns that a migraine is coming. Symptoms include changes in your mental state, such as irritability or confusion, and physical signs such as thirst or diarrhea. One out of every four migraine sufferers experiences prodrome symptoms as early as 24 hours before the migraine pain attacks.
- Aura. The phenomenon called aura is best known for its unusual visual symptoms. But other sensory, motor, and language disturbances can occur. About one in five migraine sufferers experiences aura. Aura is a phase that typically lasts about an hour.
- Pain. Migraine pain itself is often on one side of the head. It’s often a throbbing pain and may be accompanied by nausea, vomiting, and extreme sensitivity to light and sound. The pain phase can last from several to 72 hours.
- Resolution. After a migraine, many people experience deep fatigue and general malaise for up to 24 hours.
Not all migraines follow this pattern. There are migraines with and without aura. There are also migraines with and without pain. Even within the same person, migraines are extremely unpredictable.
The Symptoms of Silent Migraine
The symptoms of silent migraine include any of the typical signs and symptoms of a migraine — but without the pain.
Physical symptoms include:
- food cravings
- loss of appetite
- increased urination
Emotional and mental symptoms include:
Aura symptoms include:
- wavy or jagged lines
- flashing lights
- dots or spots in your vision
- blind spots
- tunnel vision
- disruptions in hearing
- auditory hallucinations
- distortions in smell or taste
- numbness, a pins-and-needles feeling, or other unusual body sensations
- difficulty remembering or saying a word
- other language difficulties
An American Migraine Study involved 30,000 people with migraines. Nine out of every 10 said they couldn’t work or function normally when they had migraines. More than half said they experienced symptoms severe enough to need bed rest. Even without the pain of migraine, the other symptoms can be temporarily disturbing and can disrupt your normal day.
What Causes Silent Migraines?
Researchers are now looking at migraine aura and pain as two distinct mechanisms. Doing so is leading to a better understanding of silent migraine.
In the past, experts thought migraines were primarily a problem with blood flow in the brain. That is they thought of them as “vascular” events. They now believe aura is a “neurovascular” event. That means it involves the way nerve cells are firing in the brain and how nerve cell activity relates to the brain’s blood flow. Aura appears to be a case of overstimulation and then depression of nerve cell activity in the brain.
This pattern of reduced brain activity is called “cortical spreading depression.” It literally spreads across the cortex (top layer) of the brain. When it does, it often travels from the visual part of the brain (occipital lobe) to the bodily sensation part of the brain (parietal lobe) to the hearing part of the brain (temporal lobe). This pattern mirrors the visual, sensation, and hearing symptoms common to migraine. The wave of depressed cortical activity has been confirmed by functional MRI, a high-tech way of mapping how the brain works.
Migraine pain is thought to be partly caused by blood vessels in the brain dilating. It’s thought that the swelling activates pain pathways in the nervous system.
What Triggers Silent Migraines?
Silent migraines can be set off by a wide array of triggers, including:
- physical or emotional stress
- lack of sleep
- skipped meals
- environmental stressors such as weather and extreme heat or cold
- certain foods such as chocolate, nuts, and pickled foods
- foods that contain the amino acid tyramine, including red wine and aged cheese
- hormone changes in women, such as during menstruation,pregnancy, menopause, or when taking birth control pills
- bright or flickering lights
- loud noise
How to Cope With a Silent Migraine
Headache experts may not agree on everything. But they do agree that keeping a daily diary is a critical step in diagnosing and treating your symptoms. Here are tips for coping with your migraines
- 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.
- 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.
- 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.
- 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.
- 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.
Article courtesy of webmd.com