It’s an age-old riddle: if a tree falls in the forest and no one is around to hear it, does it make a noise?
Apply that enigma to migraines: if a migraine does not hurt, is it really a migraine?
If it’s a silent migraine, the answer is yes. These strange headaches are accompanied by many symptoms of migraine, but without the pain and with distinct visual symptoms. The best way to decode this medical anomaly is to look at the 4 phases of migraine.
- Prodromal: This phase, usually occurring about 24 hours before a migraine, is when the body tells the sufferer that a migraine is on the way. Patients may feel more irritable or confused. They may also be very thirsty or suffer from diarrhea. Only about 25% of migraine sufferers have this “early warning” system.
- Aura: There are unusual visual symptoms in this phase, and 20% of sufferers experience them for about an hour. Other sensory, motor, or language disruptions can also happen during this phase.
- Attack: Most familiar of all of the phases, migraine pain is usually throbbing and comes with nausea and vomiting. Sensitivity to light and sound also occurs, and this phase can last anywhere from a couple of hours to several (miserable) days.
- Postdromal: The migraine is over, but the after effects of fatigue and sadness can linger for a few days.
This is a general guideline of how migraine works, but it can vary from person to person and even from episode to episode for the same person. A silent migraine includes all of the above phases, minus the pain, and with a few extra physical symptoms.
Silent migraine sufferers may experience extremes of the following physical symptoms:
- Food cravings and loss of appetite
- Extreme thirst and frequent urination
Their visual symptoms in phase 1 can also be extreme and include wavy lines or floating dots, flashing lights, hallucinations, difficulty with speech, and tunnel vision. Silent migraine sufferers may also temporarily lose their speech, may experience auditory hallucinations, and may have a distorted sense of smell or taste. A silent migraine is a full sensory experience that can be enough to limit the ability to function. They can last anywhere from an hour or 2 to several days, just like a migraine with pain.
Researchers are beginning to look at migraines as more than just a vascular condition, focusing on the aura of silent migraine as a neurovascular event.
This means that silent migraine may have something to do with overstimulation and then suppression of nerve activities in the brain. This may lead to increased sensitivity and heightened or changed function in those areas of the brain that control the senses. The visual component seems to be the key to distinguishing a silent migraine from another condition.
Silent migraines appear to be triggered by the same things as regular migraines (i.e., stress, fatigue, food sensitivity, hormonal changes, or changes in weather) and can be treated in much the same way. Treatments include plenty of rest, preventative care, and regular exercise. MRIs may be necessary to rule out the possibility of a more serious problem like stroke or bleeding in the brain.
Have you ever experienced these symptoms of silent migraine? How did you treat them?
Image by James Blunt via Flickr