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Silent Migraine

About Silent Migraines

What Is A Silent Migraine?

Silent migraine, also known as acephalgic or visual migraine, is a type of migraine that occurs without the characteristic headache pain. Instead of experiencing a headache, individuals with silent migraine may have various visual disturbances or other neurological symptoms associated with migraine aura. It is called “silent” because it lacks the typical migraine headache, but still presents with other migraine symptoms.

Silent Migraine Diagnosis

How Do We Diagnose A Silent Migraine?

The International Classification of Headache Disorders (ICHD) provides diagnostic criteria for silent migraine, which include the presence of migraine aura symptoms without the occurrence of a headache. Other potential causes of the symptoms, such as ocular conditions or neurological disorders, need to be ruled out through appropriate investigations.

Silent Migraine Symptoms

The symptoms of silent migraine typically last for a short duration, usually less than an hour, and resolve spontaneously without progressing to a headache. Interestingly, the fatigue and tiredness which often occur after a ’normal’ migraine are often present after the visual symptoms of a silent migraine settle down.

Visual Disturbances

Visual disturbances such as auras, flashing lights, zigzag patterns, blind spots, or other visual abnormalities.

Sensory Changes

Sensory changes such as tingling or numbness in the face or limbs.

Language Difficulties

Language difficulties such as difficulty finding words or speaking coherently.

Treating Silent Migraines With The Watson Headache® Approach

Silent Migraine Treatment

Treatment is often focused on the use of medications which target the nerve sensitivity in the brainstem. These can include triptans, CGRP (Calcitonin Gene Related Peptide) injections or Botox.

The underlying driver of migraine (brainstem sensitivity) is the same for all migraine presentations, such as dietary changes, sleep improvements, exercise, and upper neck treatment. This is why treatment of the upper neck can be effective in changing the symptoms associated with silent migraine symptoms.

Sydney Headaceha and Migraine Centre uses the Watson Headache® Approach which focuses on addressing the underlying mechanical dysfunctions in the upper neck that can be dialling up sensitivity in the brainstem, causing migraine. Skilled physiotherapists trained in the Watson Headache® Approach utilise specific manual techniques to assess and treat dysfunctions in the cervical spine and related structures. These techniques have been proven to reduce the sensitisation of the nervous system, providing relief from migraine symptoms.


For strategies to help manage Silent Migraine, read our blogs on What Causes Migraine?, Diet and Sleep Hygiene.



Cervical Referral of Head Pain in Migraineurs: Effects on the Nociceptive Blink Reflex Dean H. Watson, MAppSc; Peter D. Drummond, PhD, Headache 2014;54:1035-1045

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