Migraine without Headache: More common than we think?

In the past, migraine without headache has been considered pretty rare.  But it may be more common than we think.  Part of the reason is that many people experience migraine attacks with and without headache at different times.  I know – I’ve had migraine without headache, and migraine with headache both.

Regardless, the statistics we usually see put the number at about 3% of migraineurs, or about 0.5% to 1% of the general population.  (More on migraine statistics)

The International Headache Society lists migraine without headache as typical aura without headache, under the subset of Migraine with aura.  Previously this was typically called "silent migraine", but been confused with a host of other names like occular migraine, visual migraine, eye migraine, and so on.

But the typical aura without headache covers more than just visual aura.  Visual auras might include seeing flashing lights, or zigzags, or partial blindness, for example.  But there could be other symptoms instead, such as numbness, or feeling pins and needles.  These can be particularly tricky to diagnose.

Diagnosing migraine without headache

Often migraine without headache occurs later in life.  Part of the reason is that some people who get migraine attacks with aura and headache lose the headache over time, or start getting headaches that aren’t so "migraine-like".

Sometimes these symptoms look a lot like other issues, such as transient ischaemic attack (a "mini-stroke").  It’s important to rule out other causes (especially if you’re over 40) before you get a diagnosis of "migraine".

Doctors will want to know what type of aura you’re experiencing, and they’ll be especially interested in how long the aura lasts.  If it’s lasting less than 5 minutes, or more than an hour, that could be an extra indication of another problem.

If you suspect that you may have migraine without headache, pay special attention to the aura symptoms so you can give your doctor accurate information.

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8 comments… add one
  • niki Sep 12, 2009

    I have had many migraines without the pain in my head for years but never felt sick. My doctor told me just yesturday (after many blood tests) that the way I have been feeling for the past year (like crap) is due to these mirgraines. Ever migraine that I had, I always lost my vision but I never felt sick and not””right” until now Trying to explain this to my doctor was like trying to climb a mountain, I was frustrated and tierd. But I guess she was right because from what i read tonight I have ocular migraines. It explaines the way I have been feeling to a tee. I am glad but there is nothing I can due to stop them.

  • liza Nov 19, 2009

    I have what I call “Blithering Idiot” attacks where I become confused & disoriented. I sometimes get weak in my legs from the hips down. It feels like descriptions of demyelinating diseases, but my doctors insist that it’s all just different forms of aura, or maybe side effects from my suppressive meds. I know it’s not stroke because I have no trouble repeating simple stuff like “The sky is blue.” Migraines can do some crazy things.

  • Audrey Bennett Jan 28, 2010

    I am 48 and a long-time migraine sufferer for which I started taking Zomig in March 1999. I get 3 or 4 types of migraines; the typical ones are related to my menstrual cycle. Sometimes the pain is mild while other times I feel like a red-hot poker has been jammed into my eye socket or I have been hit in the face with a sledgehammer. I am not exaggerating. Yesterday, I think I experienced an “aura” for the first time. All day I was seeing spots in front of my eyes and had an odd smell in my nose and by around 4 p.m. I was starting to get a migraine. I attended a migraine seminar where I learned that in medieval times, people would actually have holes drilled into their heads to try and relieve the pain…I can see why!

  • Kay Feb 13, 2010

    My silent migraines seem to fulfill the atypical definition. My symptoms include: nausea, phonophobia, photophobia, confusion, slurred speech, clumsiness, numb lips and face, and vertigo.

    I very rarely have a headache and I’ve never had a visual aura (unless the spinning room counts).

  • Lena Feb 14, 2010

    I get these sometimes. I will have all the neuro stuff minus the pain. It goes away with imitex.

  • Jeff Jul 8, 2010

    My migraines Are silent.Aura begins as a small dot in my field of vision.Then progresses to resemble a backward jagged flashing c.It continues to get larger in my field of vision,until ut disapears out of my field of sight.Usually taking about 20 min. from start to finish. Depending on which side of my field of vision the Back.ward c disappears determines how I will feel after the aura is gone .If it goes to the left I will feel better after sleeping a few hours.If it goes to the right.The lethargy,eye pain,general feeling of dumbfoundness will last up to 3 days

  • Aurora Apr 24, 2013

    I no longer care if it’s a migraine without headache, I still feel like a vegetable and spend 3++ days in bed.

  • andrea Aug 30, 2017

    Curious to read that migraine aura without headache is more frequent the older we get.

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