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What Causes Migraine Aura Without Headache

The Importance Of Consulting A Doctor

Is Your Headache a Migraine Without Aura?

Its important to visit a doctor if you experience migraine aura without headache frequently. This can help rule out other conditions that cause aura or visual disturbances and get an accurate diagnosis.

Episodic aura without headache is usually not a problem. Its a nuisance. It happens maybe one or two times a year, says Dr. Digre. Its the people who get the frequent aura without headache that I want to see, evaluate and make sure that nothing else is going on.

Your doctor can conduct an examination to make sure theres no sign of a visual field defect or permanent impairment, and may also order an MRI scan or bloodwork. Blood tests can help distinguish migraine aura without headache from other conditions such as autoimmune conditions. Persistent aura can be seen with a stroke, so getting the correct diagnosis is really important.

Aura: Warning Sign Of A Migraineand A Future Stroke

Excruciating pain. Nausea. Sensitivity to light. The crushing symptoms of migraine headaches affect 15% of the population and, unfortunately, women are 3 times as likely as men to experience them.

Migraine headaches alone are bad enough. But add the symptoms related to auras and your risk of a future stroke goes up significantly.


A migraine headache with aura, known as a classical migraine, affects up to 30% of migraine sufferers. Five to 20 minutes before the onset of the headache, you see flashing lights, sparks, and dark patches. These effects might be accompanied by the feeling of pins and needles, spreading from one part of your body to another.

In some ways the aura is a good thing. Longtime sufferers recognize the aura as a warning sign of an oncoming migraine. It allows the victim to prepare, taking medication to reduce the severity of the migraine.

The migraine with aura should also be seen as a warning sign of possible stroke and heart problems.


First, the good news: In most people, migraines rarely result in a stroke. Evidence says its also unlikely that a stroke will occur during a migraine.

The not-so-good news: People who suffer migraines are more likely to eventually have some type of heart or vascular problem. A cause-and-effect hasnt been proven. In other words, the migraine with aura doesnt CAUSE the stroke. But the two do occur together.


Causes Of Migraines With Aura

The cause of migraines with aura isnt fully understood.2 Like migraines without aura they are considered a neurovascular disorder. As nerve cell activity increases within the brain, inflammatory chemicals are released, causing swelling of the cranial blood vessels. As the blood vessels swell, they activate the surrounding pain receptors, which ultimately transmit pain signals to the brain.3

Migraines with aura seem to be triggered by many of the same things that can bring on migraine without aura, including:2

  • Bright lights
  • Hormonal changes such as during menstruation
  • Changes in altitude or air pressure
  • Issues with sleep lack of, or too much

Read more about what causes migraines.

Also Check: How Common Are Visual Migraines

Do I Need A Doctor To Give An Acephalgic Migraine Diagnosis

Because acephalgic migraine is not a typical form of migraine that can be easily recognized by an individual, it often requires a healthcare provider to help make the diagnosis. So in many cases, yes, having a headache specialist or a primary care provider who’s familiar with migraine confirm a diagnosis of acephalgic migraine is useful.

Apart from acephalgic migraine, a more specific diagnosis such as migraine aura without headache or vestibular migraine or abdominal migraine would be ideal. Headache specialists, generally speaking, do not use the term acephalgic migraine, but rather prefer to make a more specific diagnosis that indicates the specific symptoms of migraine that are occurring apart from pain.

Migraine With Aura What Causes It


The cause of migraine auras is not clear, but research suggests that it is caused by an extra wave of electrical activity in the largest part of the brain called the cerebral cortex. This electrical activity, called cortical spreading depression, starts in the back of the brain where many visual areas are located, which may be why visual auras are the most common form. Scientists have shown that several migraine medications are able to alter components of cortical spreading depression.

Also Check: Why Does Caffeine Help Migraines

Trigger Factors For Other Types Of Headaches

Various lifestyle and environmental factors have been linked to other types of headaches. For example, missing your morning coffee can precipitate a caffeine withdrawal headache, which is located on both sides of the head, worsens with physical activity, and can be quite painful.

Another common type of headache is medication overuse headache, also called rebound headache. This headache occurs after frequent and excessive use of a headache or migraine medicationfor example, a triptan or a nonsteroidal anti-inflammatory .

Some daily activities like strenuous exercise, sex, or coughing can trigger headaches although these primary headache disorders are uncommon and warrant investigation by a headache specialist.

Lastly, while alcohol can trigger a persons underlying primary headache disorder, it can also cause its own headache, either as a cocktail headache or as a hangover headache. A hangover headache is throbbing, like a migraine, but is usually located on both sides of the forehead and/or temples, like a tension-type headache.

If your headaches are new or becoming more severe or frequent, a diagnosis by a healthcare professional is important.

In the end, remain dedicated and empowered in your journey to learning more about headachesbut also, be good to yourself and seek out guidance from your primary care physician or headache specialist.

Migraine Aura Without Headache

Aura is a sensory disturbance that can occur before a migraine headache. A person may see flashing lights, zigzag lines, or colored spots. In some cases, people experience aura without a headache. This is known as silent migraine.

According to the American Migraine Foundation, around 2530% of people with migraine experience aura. The symptoms usually last anywhere from 560 minutes and can precede a headache or occur on their own.

This article will cover common questions surrounding the migraine aura experience, including how and whether symptoms are associated with headaches, what a silent migraine feels like, and more.

Yes, some people experience migraine aura without a headache. This is known as silent migraine. In the past, doctors called it acephalgic migraine.

Aura refers to a group of sensory disturbances that occur at the start of a migraine episode. These disturbances develop slowly over several minutes and can last 560 minutes in total. From this point, they usually fade away as the migraine headache begins.

However, in some cases, no headache develops. With silent migraine, a person may experience nausea, light sensitivity, and other migraine symptoms, but no pain.

It is important to note that the symptoms of silent migraine can overlap with the symptoms of a stroke. If a person has any of the following, seek immediate medical attention:

  • sensory disturbances that occur suddenly

Also Check: Migraine Causing Numbness

Is It Normal To Get A Bruise Under The Skin

Bruises. A tendency to bruise easily sometimes runs in families. Occasionally after an injury, blood collects and pools under the skin , giving the skin a spongy, rubbery, lumpy feel. A regular bruise is more spread out and may not feel like a firm lump. A hematoma usually is not a cause for concern.

How Long Can An Acephalgic Migraine Last

Visual migraine aura with or without headache – Video abstract: 30999

The typical duration of a migraine attack, regardless of type, is 4 – 72 hours. The typical duration of a migraine aura is up to 1 hour. Thus, if it is migraine aura without headache, then 30 minutes or an hour would be typical, but if it is vestibular migraine or abdominal migraine, it could last up to 72 hours.

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What Does An Ocular Migraine Feel Like

An ocular migraine begins with a sparkling and shimmering area that has a jagged border and that gradually spreads outward. It causes a small blinding spot that enlarges and blocks your vision temporarily. The brightness begins at the edge of your field of vision and gradually spreads to your line of vision. Zigzag lines or stars may also be seen. It is almost like looking through a broken window. Scotoma is the area where vision is disrupted and the whole episode is called a positive aura.

An ocular migraine is often referred to differently by different experts. While many call it a visual migraine or a typical aura without headache, the International Headache Society classifies such a migraine as a silent or acephalgic migraine.

Though it seems serious since you lose your vision partially, the condition is usually harmless and will resolve on its own within 2030 minutes without any medical intervention. Complete visual darkness, or a negative aura, is not a symptom of an ocular migraine, but of some other underlying condition that needs to be investigated.2

Apart from visual disturbances, ocular migraines can also interfere with your speech. You may also feel tingling, weakness, or numbness in your hands and legs, experience size or space distortions, or feel confused. All of these, however, are rare.3

What Is Migraine Headache

Migraine aura without headache is fairly uncommon and can be hard to distinguish from other visual disturbances, so we reached out to Dr. Kathleen Digre to learn more. Dr. Digre is a distinguished professor of neurology and ophthalmology and director of the Headache Clinic at the University of Utah.

Read Also: Does Cream Of Tartar Help With Migraines

How Are Migraines Diagnosed

Despite their dramatic symptoms, migraines are almost never due to an underlying problem that will show up on any testing, even on brain MRIs. Many experts do not recommend brain imaging at all, even in severe cases, as long as the patient’s symptoms are typical for migraines and a thorough neurological examination is normal.

There are extremely rare families that have migraines as a result of a single genetic mutation in one of four known genes that can lead to the condition called familial hemiplegic migraine. There are no genetic tests for the vast majority of patients. Because the condition cannot be diagnosed by scan or blood test, the diagnosis is “clinical” made by an experienced physician.

How Can I Treat Migraines Without Using Medicines


It is very important to remember that many of the most effective preventive treatments for migraines do not require any medications. Frequent aerobic exercise is an excellent example of an effective way to improve headaches. Other strategies may include better sleep habits, stress reduction, massage, yoga, and acupuncture.

Recommended Reading: How To Cure Migraine Naturally

When Migraine Mimics Stroke

The symptoms of some types of migraine can mimic stroke, such as hemiplegic migraine where there is weakness down one side.

Migraine auras can be confused with transient ischaemic attack , where someone has stroke symptoms that pass in a short time. For instance, a migraine with only a visual aura but no headache may be mistaken for TIA.

Like a stroke, a migraine can be sudden and can lead to mild confusion. However, migraine aura symptoms tend to develop relatively slowly and then spread and intensify, while the symptoms of a TIA or stroke are sudden.

Migraine can sometimes be mistaken for a stroke caused by bleeding on the brain, called a subarachnoid haemorrhage , which is often characterised by a sudden, very severe headache. Unlike SAH, migraine headache is usually one-sided and throbbing, slow to come on and lasts for a shorter period of time. Vomiting usually starts after a migraine headache starts, but is likely to happen at the same time as headache during a SAH. Patients with a SAH also develop neck stiffness, which is uncommon during a migraine attack.

Diagnosing Migraine Aura Without Pain

Migraine aura without pain can be hard to diagnose. It can be confused with stroke or seizures. Your doctor will have to rule out other, more common, health conditions before diagnosing you with migraine aura without pain. A migraine diary is an important tool in helping your doctor accurately diagnose silent migraine.1,,2

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Are You Experiencing A Migraine Aura Without A Headache

by The Neck Care Team | Sep 15, 2017 | Headaches |

Have you ever experienced a migraine that was accompanied by visual stimulation?

Then chances are you had an ocular migraine. This type of a migraine is notable for visual symptoms . These commonly include seeing dark spots, bright spots, stars, and zigzagging lines, before the pain of a headache sets in.

However, this type of migraine doesnt always come along with a headache. Some people experience the visual symptoms without the accompanying headache or pain. This is referred to as a silent migraine.

Heres what you need to know about migraine aura without a headache if youre experiencing this problem for yourself.

Learn More About Migraine Aura Without Headache Why You Should Visit A Doctor And Available Treatment Options

2. Migraine without aura and chronic migraine

A small percentage of people with migraine experience an aura that is not followed by head pain. Migraine aura without headache is fairly uncommon and can be hard to distinguish from other visual disturbances, so we reached out to Dr. Kathleen Digre to learn more.

Dr. Digre is a distinguished professor of neurology and ophthalmology and director of the Headache Clinic at the University of Utah. She is also the immediate past president of the American Headache Society and a former president of the North American Neuro-Ophthalmology Society.

Recommended Reading: How To Prevent A Migraine When You Feel It Coming On

From A Certain Point Of View

Not everyone is as enthusiastic as Dalkara about the assertion that aura causes the pain of migraine headaches. For some researchers, the variability of auras, and their occurrence with and without headache, counts against the theory. There is very limited evidence in humans that aura is actually whats causing the pain, Charles says. Its neither necessary nor sufficient for headache.

Dalkara theorizes that the inconsistent relationship between aura and headache might be in part due to variation in the intensity and propagation of CSD events. Stronger CSDs could first generate an aura, then initiate an inflammatory cascade leading to headache, whereas weaker CSDs might cause neurological symptoms, but be too insubstantial to activate inflammatory signalling which would explain auras without a headache.

As for headaches that arise without aura, Dalkara points to a 2018 study in mice in which he showed that both sleep deprivation and depletion of the brains energy stores can also initiate the inflammatory cascades seen in migraine. This suggests that there are multiple routes to migraine headache CSD might cause pain, but perhaps not exclusively.

What Are The Symptoms Of A Migraine

Individual migraines are moderate to severe in intensity, often characterized by a throbbing or pounding feeling. Although they are frequently one-sided, they may occur anywhere on the head, neck and face or all over. At their worst, they are typically associated with sensitivity to light, noise and/or smells. Nausea is one of the most common symptoms and it worsens with activity, which often results in patient disability. In many respects, migraines are much like alcohol-related hangovers.

Migraine pain can be felt in the face, where it may be mistaken for sinus headache or in the neck, where it may be mistaken for arthritis or muscle spasm. Complicating the diagnosis of migraine is that the headaches may be accompanied by other “sinus like” symptoms, including watering eyes, nasal congestion and a sense of facial pressure. Most patients who think they have sinus headache in fact have migraines.

In up to 25 percent of patients, the migraine headache pain may be preceded by an aura, a temporary neurological syndrome that slowly progresses and then typically resolves just as the pain begins. While the most common type of migraine aura involves visual disturbances , many people experience numbness, confusion, trouble speaking, vertigo and other strokelike neurological symptoms. Some patients may experience auras without headaches.

Recommended Reading: How Common Are Visual Migraines

Is There Correlation Between Migraines And Hypertension

Many studies support the hypothesis that patients with migraine have an increased risk of developing arterial hypertension, based on common mechanisms shared by migraine and hypertension, such as endothelial dysfunction, deficiency of autonomic cardiovascular regulation, and renin angiotensin system involvement.

What About Ocular Optical & Ophthalmic Migraine

Migraine Aura Without Headache: What You Can Do

You might have heard about ocular migraine, optical migraine or even ophthalmic migraine. These are terms which may be used to describe your migraine condition by others but they are not formally recognized migraine classifications by the International Headache Society or the International Classification of Headache Disorders.

Often these are terms used by individuals or doctors who are not aware of the ICHD classifications . The terms are essentially translated to eye or eye-related migraines which isnt a particularly helpful diagnosis. The reality is many general doctors may not aware of the globally recognized standard of migraine classifications.

There is no classification for ocular, optical or ophthalmic migraine under the current ICHD-3. When someone claims they have an ocular, optical or ophthalmic migraine, then sees a qualified doctor to get an official ICHD diagnosis it is likely to fall into one of the four types of migraine with aura discussed above.

Which type of migraine with aura will depend on the symptoms experienced and diagnosis from your doctor. Below is a symptom & classification table to help you get a headstart.

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How Can These Symptoms Affect Your Life

A typical migraine usually lasts for an hour or so. However, because migraine aura without headache is not characterized by obvious pain, patients usually feel a lot of discomfort without knowing the reason. A silent migraine might cause an upset stomach, dizziness, stuffy nose or sore jaw. Most patients also feel confused and unable to function without actually understanding the reason behind the pain.

A migraine aura is not the only type of headache that affects your vision. A retinal migraine is another serious condition that affects your eyes and vision. To clarify, an ocular migraine affects both eyes while a retinal migraine usually affects one.

Although it is not very common, the latter is usually a signal of something more serious, and usually affects people who suffer from other types of migraines too. It usually involves short episodes of blindness or loss of vision in one eye. These episodes can also be accompanied by headache pain but sometimes they are pain-free.


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