migraine without aura

Migraine Without Aura: A Comprehensive Overview

A migraine without aura, also known as "common" migraine or silent migraine, is a type of migraine that occurs without the presence of visual or sensory warning signs (known as migraine prodrome) and headache. This condition is more common than any other kind of migraine, with people experiencing them as often as several times a week or as little as once a year.

Key Characteristics:

• No headache: Unlike migraines with aura, this type does not involve a throbbing headache.
• Visual or sensory symptoms: People may experience visual disturbances such as flashing lights or spots, or sensory symptoms like tingling or numbness that spreads from their hands to their face.
• Difficulty speaking: Some individuals may have difficulty speaking due to the migraine without aura.
• Premonitory symptoms: Migraines without aura can begin with premonitory symptoms such as fatigue, yawning, sensitivity to light, mood changes, and other symptoms.

Symptoms:

• Photophobia (sensitivity to light)
• Phonophobia (sensitivity to sound)
• Nausea
• Vomiting
• Aggravation of pain

Understanding Migraine Without Aura:

Migraines without aura are a complex condition with diverse symptomatology. Research suggests that the causes of migraine aura without pain or headache aren't fully understood, but keeping a journal or diary can help identify specific triggers.

References:

• [1] A silent migraine is a migraine without a headache. You may see flashing lights or spots or have tingling or numbness that spreads from your hands to your face. You may have difficulty speaking.
• [2] Once known as “common migraine,” migraine without aura is what patients are more likely to experience.
• [4] Migraines without auras are much more common than any other kind. You can get them as often as several times a week or as little as once a year.
• [5] Also known as "common" migraine, people who have migraine without aura don’t get the visual or sensory warning signs of an impending headache (known as migraine prodrome) that are classic to the other type—migraine with aura.
• [7] A migraine without aura may begin with premonitory symptoms such as fatigue, yawning, sensitivity to light, mood changes and other symptoms. As ...
• [9] A migraine causes severe, often one-sided, throbbing head pain. There are four phases to a migraine, with additional symptoms.
• [12] “Migraine aura without headache”—previously known as “acephalgic migraine” and sometimes called “silent migraine”—is when someone has a migraine aura without any head pain. Despite a lack of head pain, migraine aura without headache is still disabling for those who live with it.

Migraine Without Aura: Signs and Symptoms

Migraine without aura, also known as common migraine or silent migraine, is a type of migraine that does not involve the typical visual or sensory warning signs (aura) that precede a headache. However, people with this condition can still experience other symptoms.

Common Symptoms:

• Sensitivity to light and sound: Many people with migraine without aura become sensitive to light and sound, which can be a precursor to the headache phase.
• Nausea and vomiting: Some individuals may experience nausea or vomiting before or during the headache phase.
• Dizziness and lightheadedness: Dizziness and lightheadedness are common symptoms that can occur before or during the headache phase.
• Sensitivity to smells: Some people with migraine without aura may become sensitive to certain smells, which can trigger a headache.
• Fatigue and irritability: Feeling tired or irritable is also a common symptom of migraine without aura.

Other Possible Symptoms:

• Loss of sensation: Some individuals may experience numbness or tingling sensations in their face, arm, or leg.
• Nasal congestion: Nasal congestion or stuffiness can occur before or during the headache phase.
• Low back pain: Low back pain or discomfort is another possible symptom of migraine without aura.

Important Note:

It's essential to note that these symptoms can vary from person to person and may not always be present. If you experience any of these symptoms, it's crucial to consult with a healthcare professional for proper diagnosis and treatment.

References:

• [2] Silent migraines refer to experiencing migraine aura without headache pain.
• [5] Migraine without aura is one of two major types of migraines, and 75% of those who have the condition experience this particular kind.
• [9] With or without an aura, you also get typical migraine symptoms, which may last 4 to 72 hours. They can include: Being sensitive to light, smells, sound, motion, and touch
• [10] While migraine with and without aura are both very real conditions, there are certain difficulties that patients with migraine without aura face due to the lack of visible symptoms

Diagnostic Tests for Migraine Without Aura

Migraine without aura, also known as common migraine, is a clinical diagnosis that relies on symptoms and history reported by the patient to their healthcare provider. While there is no surefire test for detecting the presence of migraine, doctors can point to several factors and symptoms to make a diagnosis.

Diagnostic Criteria

The diagnostic criteria for migraine without aura include:

• Unilateral pulsatile headache lasting 4-72 hours that may be aggravated by physical activity or head movement [8]
• At least five attacks fulfilling criteria B-D [7]
• Headache attacks lasting 4-72 hours (untreated or unsuccessfully treated) [7]

Screening Instruments

Validated screening instruments for migraine without aura include the three-item ID-Migraine questionnaire and the five-item Migraine Screen Questionnaire (MS-Q) [5].

Clinical Diagnosis

The diagnosis of migraine without aura is made by applying the International Classification of Headache Disorders Third Edition subsection for migraine without aura (ICHD-3 subsection 3.1.1) [9]. A healthcare provider will consider the patient's symptoms, medical history, and other factors to make an accurate diagnosis.

References

• [5] Eigenbrodt AK. Validated screening instruments for migraine. Cephalalgia. 2021;41(10):1023-1032.
• [7] International Headache Society. The International Classification of Headache Disorders, 3rd edition (ICHD-III). Cephalalgia. 2018;38(1):1-211.
• [8] Paemeleire K. Migraine without aura: a review of the literature. Journal of Headache and Pain. 2023;24(1):1-11.
• [9] International Classification of Headache Disorders, Third Edition (ICHD-III). Cephalalgia. 2018;38(1):1-211.

Treatment Options for Migraine Without Aura

Migraine treatment is aimed at stopping symptoms and preventing future attacks. For migraine without aura, there are several treatment options available.

• Acute Medications: These medications are used to treat a headache attack as it occurs. They can help break the headache cycle and provide relief from symptoms.
• Preventive Treatment: This type of treatment is aimed at reducing the frequency and severity of migraine attacks over time. Preventive treatments include:
  • Beta-blockers
  • Tricyclic antidepressants
  • Anti-epilepsy drugs
• Lasmiditan: A newer oral tablet approved for the treatment of acute migraine with or without aura. Lasmiditan has been shown to be effective in treating migraine attacks and may offer a new option for patients.
• Other Medications: Other medications such as triptans, NSAIDs, and anti-nausea medications may also be used to treat migraine without aura.

Treatment Plans

The treatment plan for migraine without aura will depend on several factors, including:

• The frequency and severity of attacks
• Other health conditions or medications being taken
• Individual patient needs and preferences

It's essential to work with a healthcare provider to determine the best course of treatment for each individual case. They can help explore these options and develop a personalized plan.

References

1. Treatment options for migraine without aura depend on how often you have attacks and how severe they are [4].
2. Preventive treatment such as beta-blockers, tricyclic antidepressants or anti-epilepsy drugs [4].
3. Lasmiditan is a targeted anti-migraine drug that is both safe and effective [7].
4. Migraine headaches can be treated with two drug approaches: abortive and preventive [9].