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.