Causes And Risk Factors
Although the exact physiology of retinal migraine is unknown, one theory is that it may result from vasospasm, a narrowing of vessels that supply blood to the retina or that are part of the ciliary body of the eye.
Whatever the mechanism, like all types of migraine headaches, retinal migraines tend to be brought on by specific triggers such as stress, high blood pressure, smoking, and more.
Retinal migraines, in particular, may be triggered by:
- Staring at a screen for long periods
- Spending time in fluorescent or other harsh lighting
- Driving long distances or participating in other taxing visual activities
People believed to be at increased risk of retinal migraine headaches include those who:
- Are in their 20s or 30sin particular women, due to hormonal changes related to the menstrual cycle
- Have a history of other types of migraine
- Have a family history of migraine headache
- Have lupus, atherosclerosis, or sickle cell disease
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What Causes Vestibular Migraine
Vestibular migraines, like other migraine syndromes, tend to run in families. Although science has not completely clarified the complex mechanisms of migraine, it is known that women tend to suffer more from the condition than men, and symptoms may get worse around menstruation.
In addition, people vulnerable to vestibular migraines can experience episodes after migraine triggers including altered sleep patterns, MSG, menstrual cycle and food such as chocolate, ripened or aged cheese and red wine.
How Prevalent Are Migraines
Migraines are about three times more common in women than men, and may affect more than 12 percent of the U.S. adult population. Migraines often run in families, and can start as early as elementary school but most often in early adulthood. They often fade away later in life, but can strike at any time. The most common cause of recurring, disabling headache pain, migraines are also the most common underlying cause of disabling chronic, daily headache pain. While migraines are the No. 1 reason that patients see a neurologist, most cases are handled by primary care physicians.
Things that can make the headaches more likely to occur include:
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Types Of Migraine Auras Visualized And Explained
Even if no headache is involved, silent migraines can be extremely disruptive to daily activities. The classic “half-moon” visual disturbance , alterations in color perception, and other vision problems are also common.
A silent migraine can last from 15 to 30 minutes, but it is usually no longer than 60 minutes. It can recur or appear as an isolated event.
Common Symptoms Of Migraine Aura Without Headache
Most people that experience visual symptoms of silent migraines have the same symptoms.
Healthline states that the most common of these visual symptoms include seeing:
- Flashing or flickering lights
- Spots, stars, halos of colorful light
- Blind spots, dark spots, light spots
- Temporary loss of vision
- Shimmering effects
Despite the lack of a headache, those suffering from this unique condition also commonly experience additional symptoms including:
- Tingling or numbness in body
- Odd sensations/feelings in arms, hands, face, and tongue
- Pins and needles sensation in feet
- Difficulty speaking
Note that some people experience migraine auras without headaches at certain times and with headaches at others.
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What Is Migraine Aura Without Pain
Migraine aura without pain includes changes in vision or changes in the other senses and speech but no head pain. Symptoms gradually build over 5 to 20 minutes and then go away after about 1 hour. The lack of head pain sets it apart from other types of migraine with aura. Also, no other disorder can be found to be blamed for the symptoms.1
What Are The Short
An isolated migraine without a headache typically does not require any acute treatment. The first few times someone experiences a visual migraine it usually causes some anxiety. That anxiety, however, usually subsides once they become familiar with the symptoms.
Some patients are able to tell when a headache is beginning. They may find that early use of simple strategies can nip a mild headache in the bud. These simple strategies include such things as eating, having caffeine, meditating or taking an over-the-counter medication such as acetaminophen or ibuprofen.
When headaches are moderate or severe, additional treatment may be needed. Most headache medications work best when they are taken in time to stop the headache before it becomes too severe. If vomiting is a problem, patients may require non-oral medicines such as injections or rectal suppositories. Some patients find over-the-counter combinations of simple analgesics in combination with caffeine to be helpful. Other patients try a class of prescription medications known as triptans.
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How Is Silent Migraine Treated
For disorders, doctors use two types of drugspain relievers and preventive medicines. Pain relievers are not much use for silent migraines since there is no headache . Preventive medicines can be helpful if silent migraines are frequent, last a long time, or interfere with functioning. When silent migraines are infrequent and short, treatment may not be necessary. Keeping a symptom diary can help you and your doctor decide whether to start treatment or not.
Common types of preventive migraine medicines include:
Anticonvulsants or antiseizure drugs, which have various effects in the brain
Antidepressants, which balance brain chemicals that likely play a role in migraine
How To Prevent Migraines
Prevention is better than cure, and so is the case with a Migraine. It is always better as compared to the treatment of any of the types of migraines. One of the best ways to do this is by maintaining a journal of food and activity to track the possible triggers. This is also helpful in pattern identification which is useful in avoiding migraine triggers.
Common migraine triggers include:
- Strong odors, cigarette smoke, and perfumes
- Additives, such as Monosodium Glutamate and Artificial Sweeteners
- Food, such as aged cheeses, smoked meats, caffeinated beverages, chocolate, as well as wine
Finally, the important step is to minimize stress. The key to minimizing pain can be, learning how to manage stress through healthy lifestyle habits.
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The Effect On Patients
Research is a bit limited, but we know that migraine presents patients with a high burden from different symptoms. For a patient whos having visual aura that comes on in situations like driving, it can be very disconcerting. It definitely affects day-to-day functioning, even if headache and other features arent there. This is especially true if its the first time is happens or theres a change in how it presents. Typical aura without headachethe silent migrainecan be quite scary.
Jennifer Robblee, MD, is part of the Mayo Clinicin Scottsdale, Arizona
Signs And Symptoms Of Migraine
Symptoms of migraine vary depending on the type of migraine and on the person. In general, though, migraine attacks are very painful and can interfere with your daily life.
The most common symptom of migraine is head pain often characterized as an intense throbbing sensation, usually on one side of the head but sometimes on both sides of the head, and sometimes starting on one side of the head and moving to the other side.
However, migraine attacks have four stages, with somewhat different symptoms at each stage:
Prodrome, or Warning, Stage
Aura Stage Up to a third of people experience the aura phase, which can last five minutes to an hour and increase in intensity over time. Aura may involve seeing bright spots or patterns of light, and numbness or tingling in various areas of the body but not paralysis.
Headache Phase Pain comes with the headache phase, which can last several hours and up to three days. The throbbing pain may start on one side of the head and move to include both sides. It may be accompanied by nausea and vomiting as well as blurred vision and sensitivity to certain stimuli such as light and noise. People typically seek out a quiet, dark room to rest or sleep during this phase of a migraine attack.
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Causes Of Migraine Aura
Migraines generally have four phases: prodrome, aura, headache attack, and postdrome. Not everyone with migraines experiences all four phases. The aura phase, which usually lasts an hour or less, is when visual disturbances are experienced. It can also coincide with headache and other migraine symptoms.
Different types of brain activity have been measured during migraines with aura. They show changes in blood flow and metabolism in the occipital cortex, an area of the brain that affects vision. Cortical spreading depression is a slowly spreading wave of changing brain activity. It has been associated with visual aura in migraines. The slow spread of brain disturbance is believed to correspond with the gradual onset and duration of aura.
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What Causes Abdominal Migraine
The cause of abdominal migraine is unknown. We dont know the exact connection between an abdominal migraine and a classic migraine, but we do know theres a connection between the gut and the brain, says Deena Kuruvilla, MD, a neurologist and specialist in facial and headache pain at Yale Medicine. Many of the drugs we use to treat depression, for example, are effective in treating an abdominal migraine.
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Implications For Future Trials
Patients with migraine with aura, may have attacks with and without aura and most had more than one subtype of migraine with aura . Even though few patients report only MA, the group having both MO and MA is often substantial, and is it therefore important to classify each individual attack being treated according to the International Classification of Headache Disorders, as suggested by the International Headache Society clinical trials subcommittee . The trials of tonerbasat showed efficacy in migraine with aura, but not in migraine without aura, suggesting that migraine with and without aura should be studied separately .
Trials of migraine prophylactic drugs generally focus on reduction in the number of migraine days as the key efficacy parameter, and little attention has been paid to the influence of these drugs on the occurrence of auras.
Future studies should have a clear distinction between aura and non-aura headaches. Other modifying factors, as attack frequency and treatment is also needed to understand how imaging changes is related to clinical outcomes.
Migraine Aura Without Pain
A migraine aura without pain is usually called typical migraine aura without headache pain. The symptoms usually build up from 5 to 20 minutes and dont last that long. This is usually called the march of symptoms. To clarify, this is where symptoms gradually increase until they reach the maximum level. After that, they decrease until they go away.
However, most of the time, there is no headache pain associated with the other symptoms. However, because no other disorder can be blamed for the offset of symptoms, the patients are successfully diagnosed with this condition.
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Treating Migraine Aura Without Headache
When migraine aura without headache is frequent or severe, your doctor can recommend treatment options, such as low dose aspirin, calcium channel blockers or other medications.
My favorite treatment has been baby aspirin, if they dont have any contraindication for baby aspirin, says Dr. Digre. Calcium channel blockers often will treat aura without headache if its frequent.
For people who experience onset of migraine aura later in life, the symptoms can be very severe and last for several days. In that case, Dr. Digre usually prescribes a calcium channel blocker, but other medications can be used.
There arent any specific lifestyle adjustments to treat migraine aura without headache. However, taking steps like getting adequate sleep, decreasing stress and avoiding known migraine triggers may help prevent aura without headache.
The American Migraine Foundation is committed to improving the lives of those living with this debilitating disease. For more of the latest news and information on migraine, visit the AMF Resource Library. For help finding a healthcare provider, check out our Find a Doctor tool. Together, we are as relentless as migraine.
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What Are Some Migraine Risk Factors And Triggers
Some things make you more likely to get migraine headaches . Other things may bring on a migraine .
Common migraine risk factors include the following:
- Family history: You are much more likely to have migraines if one or both of your parents had migraines.
- Sex: Women are more likely than men to have migraines.
- Age: Most people have their first migraine during adolescence, but migraines can start at any age, usually before age 40.
Common migraine triggers include the following:
- Food and drink: Certain food and drink may cause migraines. Dehydration and dieting or skipping meals may also trigger migraines.
- Hormone changes: Women may experience migraines related to their menstrual cycles, to menopause, or to using hormonal birth control or hormone replacement therapy.
- Stress: Stress may trigger migraines. Stress includes feeling overwhelmed at home or work, but your body can also be stressed if you exercise too much or dont get enough sleep.
- Senses: Loud sounds, bright lights , or strong smells may trigger migraines.
- Medicines: Certain medicines may trigger migraines. If you think your migraines might be related to your medicine, talk to your doctor. Your doctor may be able to prescribe a different medicine.
- Illness: Infections, such as the cold or the flu, may trigger migraines, especially in children.
Foods that may trigger migraines:
- aged, canned, cured, or processed meat
- aged cheese
- soy sauce
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Migraine With Brainstem Aura
People who have migraine with brainstem aura experience visual symptoms that are similar to migraine aura. However, symptoms can also occur in just one eye. The condition is characterized by headaches in the back of the head that span both sides of the head. The condition is rare and occurs more commonly in adolescent girls.
What Is Migraine Aura Without Headache
For most people, a headache follows the aura. But some people dont get the headache they just get the aura, says Dr. Digre. That is what is known as migraine aura without headache.
Migraine aura without headache is not very common. Only about 4% of people with migraine have aura without headache. It commonly occurs in two age groups: young adults in their 20s and 30s, and older adults between 40 and 60 years old.
People who have migraine with aura with headache, sometimes will lose their headache as they get older. So the headache part goes away, and the aura continues, says Dr. Digre. Almost 40% of people whove had migraine with aura in later life will get aura without headache.
Migraine aura without headache is sometimes referred to as ocular migraine, a common misnomer. Ocular migraine is not even in the International Classification Of Headache Disorders, explains Dr. Digre, It doesnt exist.
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Foods And Food Additives
Certain foods and beverages, particularly alcoholic beverages, can be triggers. The flavor enhancer monosodium glutamate can also be a trigger, as can caffeine.
Foods containing the amino acid tyramine have been associated with migraine onset. Examples include aged cheese, smoked fish, chicken livers, figs, certain beans, and red wine.
The nitrates in cured meats such as bacon, hot dogs, salami, and other lunch meats are a trigger for some.
Research has also suggested that the artificial sweeteners aspartame and sucralose can be triggers.
And for some people, fruits such as avocados, bananas, and citrus as well as some nuts and seeds can trigger migraine.
Missing or skipping meals can trigger attacks, too.
One approach to discovering migraine food triggers is to try an elimination diet, in which certain foods are eliminated from the diet for a few weeks, then reintroduced one at a time to see whether a migraine attack occurs.
However, a given food does not always trigger a migraine attack sometimes another trigger, such as a change in the weather, also has to be present for an attack to take place. Or a certain amount of food has to be consumed before it has an effect, according to an article published in June 2020 in the journal Nutrients.
For that reason, most experts recommend consulting your physician before trying an elimination diet for migraine and, if you do decide to try it, working with a registered dietitian to maintain good nutrition.
What Causes Ocular And Visual Migraines
The exact cause of an ocular migraine can be difficult to pinpoint. But it’s believed they occur for the same things that cause migraine headaches.
Migraine headaches have a genetic basis, and some studies say that up to 70% of people who suffer from the disorder have a family history of migraine.
According to the World Health Organization , migraines are caused by the activation of a mechanism deep in the brain that leads to release of pain-producing inflammatory substances around the nerves and blood vessels of the head.
Studies have shown changes in blood flow to the brain during ocular migraines and migraine auras . But exactly why this happens remains unclear.
Common migraine “triggers” that can cause a person to have a migraine attack include:
Stress and lack of sleep also can trigger an ocular migraine or visual migraine.
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Updates On The Clinical Features Of Migraine Especially Migraine With Aura
Randolph W. Evans, MD
Although we see migraineurs almost daily and over 50 percent of us are migraineurs,1 a review of the clinical features may be of interest.
Migraine has a one-year period prevalence of 12 percent and2 some 35 million people annually have migraine in the United States. The cumulative incidence of migraine by age 85 is 18.5 percent in males and 44.3 percent in females with onset before the age of 25 in 50 percent of cases, in 75 percent before the age of 35 years, and only two percent over the age of 50.3 The median age of onset is 25 years. About 8 percent of boys and 11 percent of girls have migraine.4 Chronic migraine, with attacks occurring on 15 or more days per month for at least three months, occurs in about 3.2 million people per year in the United States, 80 percent women.5