Silent migraines may sound like a paradox, but they can be just as debilitating as regular migraines. For patients suffering from chronic silent migraines, the impact on their quality of life is equal to those who experience chronic migraines with headache pain. Some migraineurs have been known to experience a constant silent migraine for indefinite periods of time. In some instances, these attacks can last for years.

What is Chronic Silent Migraine?

Although silent migraines are not officially recognized by the International Headache Society, estimates show up to 20 percent of migraineurs have experienced an attack without headache pain. These have been given various labels over the years, including:

• Isolated visual migraine
• Ocular migraine
• Optical migraine
• Acephalgic migraine
• Aura without headache
• Migraine equivalent

When you apply the same criteria to silent migraine as doctors use for standard migraine, a condition lasting or recurring for more than 15 days out of every 30 qualifies as chronic silent migraine.

Symptoms of Chronic Silent Migraine

The symptoms of a silent migraine are almost identical to those of a standard migraine, with the exception of the headache pain. Sufferers report experiencing visual disturbances including flashing lights, halos, or spots of light, blurry or cloudy vision, or seeing dark areas in their field of vision.

Sensory symptoms include numbness and tingling in the extremities, feelings of weakness, vertigo or dizziness, confusion, speech disturbances or loss of hearing. These may also be accompanied by abdominal pain, nausea, and vomiting.

Many patients also go through four similar phases as a standard migraine attack, which are:

• Prodrome phase, during which patients typically feel confused, irritable, tired, or unusually thirsty. They may also experience diarrhea.
• Aura phase, which can last from a few hours to several days and bring disruptions of vision, language, and mobility.
• Pain phase, characterized by vomiting and nausea, sensitivity to light, touch, or sound. This is usually the period when the patient also experiences headache pain, but with silent migraines sufferers typically have everything else except that.
• Postdrome phase, when patients feel drained and exhausted and often experience depression.

Often, the symptoms can last for years at a time. One patient reported having daily aura for 2 years, while another experienced the effects of a migraine attack without the pain constantly for up to 12 years.

Causes of Chronic Silent Migraine

Patients with a higher risk for chronic silent migraines include women over 40 years, particularly if they are menstruating, pregnant or experiencing menopause, and patients with a family history of migraine. The various types of migraine attacks have multiple triggers, including:

• Sound
• Light
• Stress
• Odors
• Air pressure
• Medication
• Hormonal changes

These triggers set off an electrical depression in the brain, resulting in changes in brain activity and blood flow. This begins typically in the occipital lobes at the back of the head, which are recognized as being related to aura common in migraine attacks.

Solutions for Chronic Silent Migraines

Prevention is the preferred solution for chronic silent migraines, so it’s important to identify your triggers and learn how to avoid or counteract them. Keep a migraine diary to help you distinguish patterns in your wellbeing and align those with your activities.

Maintain a healthy diet, a regular exercise program and a routine sleep pattern. Avoid caffeine, alcohol, and chocolate if those appear to spark a silent migraine, although in some instances patients find caffeine to be helpful at staving off the attacks.

Be prepared with over-the-counter medication such as NSAID painkillers to alleviate the symptoms, and natural therapies to help you relax. Work with your migraine doctor to find out which of the prescription medications help and keep a supply of those with you at all times. Many chronic silent migraine sufferers find they can function fairly normally most of the time, because in spite of the symptoms they experience, the pain itself doesn’t affect them.

Get confirmation from your doctor that you aren’t at risk for other conditions such as stroke, which could mimic the symptoms of chronic silent migraine and be fatal if left untreated. Consider whether to be open about your condition at work, so that your co-workers are understanding. Even if you don’t suffer from headache pain, a chronic condition can affect your performance significantly.