Silent, Ocular or Retinal Migraine?
Migraine is commonly associated with debilitating headache. However, not all migraine involves pain. This condition is diagnosed as ‘migraine aura without headache’. So, what is an aura?
The Aura
An aura is a temporary and reversible neurological phenomenon that often precedes or accompanies migraine pain, typically lasting between 20 to 30 minutes. This phenomenon may involve a range of symptoms, including visual disturbances (such as flashing lights, zigzag patterns, or blind spots), sensory changes (like numbness or tingling) usually occurring on one side of the body, affecting an arm or a leg or both, or difficulties with speech. While it is frequently associated with migraine, an aura does not always lead to a headache and is triggered by changes in brain activity and blood flow. Recognising an aura can help individuals effectively prepare for or manage their migraine symptoms; for example, the best practice is to take medication at the first sign of a migraine – for some, it is an aura.
Aura Only?
‘Silent migraine’ is another term for ‘migraine aura without headache’, the type of migraine in which individuals experience the neurological symptoms typically associated with a migraine but do not have the accompanying headache. This makes silent migraine a complex and often misunderstood condition.
Silent migraine is sometimes called ‘ocular migraine’ when the main symptom is visual disturbance. These disturbances can appear as flashing lights, zigzag patterns, blind spots, or even temporary vision loss in one eye. However, it’s important to understand that ‘ocular migraine’ is often used interchangeably with ‘retinal migraine’, which is a specific and rare type of migraine that involves temporary vision loss or blindness in one eye. This can lead to confusion, so it’s essential to use precise terminology when discussing these conditions.
Cause and Triggers
The exact cause of silent migraine is not fully understood, but they are believed to involve changes in brain activity and blood flow. Triggers for silent migraine are similar to those for other types of migraine and can include stress, hormonal changes, certain foods, dehydration, or prolonged screen time. While silent migraines may not involve pain, they can still significantly impact daily life, especially if symptoms like visual disturbances or sensory changes interfere with work or other activities. For instance, I treated a grandmother who regularly experienced vision loss and was often anxious about taking her very young grandchildren in the car.
Pro-Action
If you or someone you know experiences symptoms of a silent migraine for the first time, it’s crucial to seek medical advice. A proper diagnosis is vital for ruling out other conditions, such as transient ischaemic attacks (TIAs) or other neurological disorders. Treatment usually involves identifying and managing triggers and exploring preventive strategies. Understanding silent migraine can help minimise their impact and enhance the quality of life for those affected.
