What is a Silent Migraine?

Understanding Silent Migraines

Silent migraines are thought to happen when the brain becomes unusually sensitive, leading to a temporary change in how nerve cells communicate. One theory involves a wave of electrical activity, called cortical spreading depression, which moves across the brain and can trigger migraine aura symptoms such as visual changes or tingling sensations.

Certain brain chemicals,  including calcitonin gene-related peptide (CGRP), also play a role by influencing how nerves send signals and how blood vessels behave during a migraine attack.

You may be more likely to experience silent migraines if you have a family history of migraine, other neurological disorders, or common migraine triggers such as stress, bright lights, loud noises, irregular sleep, or hormonal changes.

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Silent Migraine Symptoms

Although there are no headache symptoms as experienced in a typical migraine attack, silent migraines can produce a range of symptoms, often classed as positive (added sensations) or negative (loss of function):

Visual Symptoms:

• Flickering or flashing lights
• Wavy or jagged lines
• Blind spots or blurred vision
• Sensitivity to bright lights

Sensory Symptoms:

• Tingling or numbness in the face or limbs
• Difficulty speaking or finding words
• Dizziness, unsteadiness, or vertigo
• Sensitivity to loud noises and strong smells

Other Symptoms:

• Nausea
• Fatigue and low energy
• Mood changes or irritability
• Cognitive fog or a migraine hangover during the postdrome phase 

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Phases of a Silent Migraine 

1. Prodrome Phase: Early warning signs such as fatigue, neck stiffness, food cravings, or difficulty concentrating, hours or days before the aura.
2. Aura Phase: Visual, sensory, or speech disturbances that develop gradually and typically last 5–60 minutes.
3. Postdrome Phase: Fatigue, sensitivity to light or sound, and cognitive slowing for up to 24 hours. 

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Silent Migraine vs Typical Migraine 

The main difference is the absence of the headache phase. Both share similar triggers, aura patterns, and postdrome effects. Vestibular migraine is another migraine variant that can present with or without head pain, accompanied by dizziness and balance problems. Learn more about Vestibular migraine here.

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Causes and Triggers

Silent migraines share the same triggers as other migraine types. Common migraine triggers and environmental factors include:

• Stress or sudden changes in stress levels.
• Hormonal shifts.
• Disrupted sleep patterns.
• Certain foods and drinks (e.g. caffeine, alcohol, processed meats).
• Sensory overload from bright lights or loud noises.
• Weather or barometric pressure changes.

Research from the American Migraine Foundation and The Migraine Trust suggests a combination of genetic risk factors, medical history, and environmental triggers influences who will experience migraine, including silent types.

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Diagnosis 

Accurate diagnosis is essential for effectively treating silent migraines. Because a silent migraine involves aura without headache, it can be mistaken for other neurological disorders such as transient ischaemic attack (TIA), seizure activity, or vestibular conditions.

A healthcare provider will typically assess your medical history, review your symptoms, and may order tests such as an MRI, CT scan, or even a spinal tap to rule out more serious conditions. An accurate diagnosis is important to ensure safe and effective treatment.

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Treatment and Management 

Treatment plans for silent migraines are often similar to those for typical migraine and focus on: 

• Avoiding environmental triggers.
• Acute medications to shorten or reduce symptoms (triptans, anti-nausea medications).
• Preventive therapies (beta blockers, CGRP inhibitors, certain anti-seizure medications).
• Lifestyle strategies such as regular sleep, hydration, and stress management.

At Sydney Headache & Migraine Clinic™, we take a unique approach by assessing the upper cervical spine and brainstem for dysfunction that may be contributing to your symptoms. If we find a sensitised brainstem, we use safe, gentle, and non-invasive methods to help restore normal function. It’s our aim to reduce your migraine frequency and severity without over-reliance on medication.

 

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When to Seek Medical Attention 

While a silent migraine is not usually life-threatening, some symptoms overlap with serious conditions such as stroke. Seek urgent medical attention if you experience:

• Sudden visual changes in one eye.
• Weakness, numbness, or paralysis on one side of the body.
• Trouble speaking or understanding speech.
• Loss of consciousness.

Prompt assessment ensures you get the right diagnosis and treatment — and peace of mind.

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Book Your Assessment 

If you suspect you may be experiencing silent migraines, book an initial consultation at Sydney Headache & Migraine Clinic™. During the assessment, we’ll take the time to understand your symptoms, assess whether neck or brainstem dysfunction may be contributing, and discuss whether our approach could form part of a personalised management plan.