Acephalic migraine, also known as silent migraine, is a type of migraine without a headache but with other symptoms such as nausea, vision changes, and weakness. It can occur in both children and adults, and some populations may be more prone to it. The duration of symptoms can vary, and repeated episodes may lead to an accurate diagnosis. Treatment options depend on the severity of symptoms and patient needs.
Acephalic migraine is best understood when it is called migraine without headache or is sometimes referred to as silent migraine. Most people think of migraines as severe headaches, but they include other symptoms such as nausea, vision changes, sensitivity to light, and conditions such as weakness in one side of the body. When these additional symptoms are present, but a person has only a mild headache or no headaches, they may still have migraines or be diagnosed with an acephalic migraine.
Just as with migraines in which a headache is present, both children and adults can develop acephagia types of migraine. Some populations seem more prone to them. For example, women are likely to develop them in their mid to late 40s and beyond. Having migraines without headaches may be an indication that people will later develop migraines with headaches. This especially occurs when children get these silent migraines, but some people won’t progress to getting the headaches normally associated with migraines.
The duration of an acephalic migraine is not always predictable. Sometimes people experience the gathering of non-headache symptoms for a few hours. Other times the symptoms may only last a few minutes or seconds and the experience is so brief that people dismiss it. It may not be brought to the attention of a doctor unless a large number of these strange episodes occur.
If people have repeated episodes of acephalic migraine, they usually get an accurate diagnosis from a doctor. Sometimes the diagnosis goes wrong, particularly if unilateral body weakness presents with visual disturbances. Especially in older populations, clinicians might consider a diagnosis of transient ischemic attack (TIA) or mini-stroke. With continued expression of this condition, the diagnosis is likely to be reversed. Another potential differential diagnosis is epilepsy, and it is the case that if nonmigraine migraine symptoms are accompanied by seizures, a seizure disorder might be the correct diagnosis, while acephalic migraine would be incorrect.
While a severe headache may not be a problem with acephalic migraine, the other symptoms can prove disorienting and uncomfortable. Once a person has been diagnosed with this condition, doctors might make recommendations on the best medications to treat symptoms. These might include traditional migraine medications, but managing symptoms such as nausea, with antiemetics, may be all that is needed to produce greater comfort. What doctors and patients decide to use depends on the severity of the episodes and the patient’s needs, and needs may change over time.
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