The Migraine with No Headache: What You Need to Know About Silent Migraines

Have you ever experienced sensitivity to light, sounds, or smells, visual disturbances, nausea, or dizziness, but didn’t have the accompanying head pain that is usually associated with migraines? You may be experiencing silent migraines. Silent Migraines can often be known as the “quiet” migraine you didn’t see coming and so people often overlook the correlation and focus on the singular symptoms which are disruptive in their own way but often lack the hallmark symptom of head pain. Silent Migraine sufferers may not even realize it’s a migraine at all – and that’s where the consultation of a neurologist can help clarify and determine the root cause and provide care management to help navigate these challenging onsets before they happen.

What is a silent migraine?

A silent migraine, also called migraine with aura, refers to a migraine that occurs without the typical throbbing headache sensation. Even in the absence of head pain, a person may still feel the typical symptoms of migraines such as sensitivity to light, sounds, or smells, visual disturbances, nausea, or dizziness. 

What happens neurologically when you’re having a silent migraine?

When a patient is experiencing a migraine without the typical pain that is associated with headaches, they often have neurological symptoms such vestibular symptoms or changes in vision (streaking lines, blurring, or fog), numbness or tingling, clogged ears, increased irritability, increased sensitivity, brain fog, and fatigue.

These symptoms are a result of the brain’s sensory and language processing centers being affected by the suppression of the occipital lobe (visual center of the brain), which helps explain the visual symptoms and disturbances that many experience. 

Are silent migraines painful?

Although silent migraines are typically not as painful, these visual and neurological symptoms can still be very disruptive. These symptoms can impede daily activities and even cause patients to call out of work. This may include difficulty using computer and phone screens, trouble driving, sensitivity to bright lights, brain fog, trouble concentrating, focusing, or forming words. This can prevent people from caring for their family members, and significantly decrease their quality of life. While they don’t experience the typical headache symptoms, the discomfort they feel comes from the impact on their lives and time it might take to understand this condition.

How long do silent migraines last?

Silent migraines, just like typical migraines, can be chronic. While everybody is different, most silent migraines last anywhere from fifteen minutes to an hour. However, just like a typical migraine, silent migraines occur in phases. The first phase, called the prodrome, can begin 24 hours before the main symptoms, which present as subtle warning signs like irritability, sensitivity, food cravings, and fatigue. 

Next comes the aura phase, typically lasting an hour, which brings more visual disturbances such as flashing lights, wavy lines, seeing spots, and tunnel vision. And the last phase, called the postdrome, can last several hours or even into the next day. During this phase, a person might feel mentally drained, foggy, or physically fatigued, even though the more intense symptoms have passed.

What are the warning signs you’re having a silent migraine?

The most common symptoms for silent migraines are visual changes like shimmering or streaking patterns, blurring, and blind spots. Some people also experience tingling or numbness on one side of the body, and mental fog. These neurological signs and symptoms should not be ignored; consult a specialist if these symptoms persist.

What is the best way to treat a silent migraine?

As a general rule of thumb, the longer you take to address the migraine the harder it is to treat. The best treatment is to get ahead of them. Pay attention to what triggers your silent migraines—common culprits include certain foods or drinks, changes in sleep patterns, hormone fluctuations, stress, or even sensory overload. Keeping a migraine diary can help you spot patterns and avoid future episodes.

If you do start to feel the early signs, acting quickly is key. Some people find relief with over-the-counter anti-inflammatories like ibuprofen, while others may need prescription medications such as triptans or CGRP inhibitors—especially if they experience frequent or intense auras.

Lifestyle strategies also play a big role: staying hydrated, getting consistent sleep, managing stress, and eating regular, balanced meals can help reduce the likelihood of attacks. Exercise also helps prevent migraines. 

What symptoms warrant a visit with a Neurologist?

While many people experience occasional headaches, it’s important to know when symptoms require medical attention. If your silent migraine symptoms persist for more than 10 days, you should consult a board-certified neurologist to identify the root cause and determine the appropriate treatment.

In general, any headache that feels unlike those you’ve had before is considered a red flag and should be evaluated by a migraine specialist.

Additionally, any new or unfamiliar symptom, or if a headache feels different than usual, should not be ignored. Sudden changes, such as difficulty speaking, understanding language, seeing clearly, or weakness in the face or limbs, may be signs of a stroke and require immediate medical attention. Call 9-1-1 right away if you experience these symptoms.

Additional Resource: Podcast Episode Featuring Migraine Expert Dr. Ella Akkerman, a Board-Certified Neurologist