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What is an Acephalgic Migraine?

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  • Written By: Tricia Ellis-Christensen
  • Edited By: O. Wallace
  • Last Modified Date: 04 November 2016
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Acephalgic migraine is better understood when called a migraine without headache or it is sometimes referred to as a silent migraine. Most people think of migraines as severe headaches, but they include other symptoms like nausea, visual disturbances, sensitivity to light, and conditions such as body weakness on one side. When these additional symptoms are present, but a person has only a slight headache or no headache at all, he still may have migraines or be diagnosed with having an acephalgic migraine.

Just as with migraines where a headache is present, both children and adults may develop acephalgic migraine types. Certain populations seem more prone to them. For instance, women are likely to develop them once they are in their mid to late 40s and thereafter. Having migraine without headache can be an indication that people will later go on to develop migraines with headaches. This especially occurs when children get these silent migraines, but some people will not progress to getting the headaches normally associated with migraines.

The length of an acephalgic migraine isn’t always predictable. Sometimes people experience the collection of non-headache symptoms for a few hours. Other times symptoms may last for just a few minutes or seconds, and the experience is so brief people dismiss it. It might not be brought to the attention of a physician unless a high number of these odd episodes occur.

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If people have repeated episodes of acephalgic migraine, they’ll usually receive accurate diagnosis from a doctor. Sometimes diagnosis goes awry, particularly if one-sided body weakness presents with visual disturbances. Especially in older populations, doctors might consider a diagnosis of transient ischemic attack (TIA) or mini-stroke. With continued expression of this condition, diagnosis is likely to be reversed. Another potential differential diagnosis is epilepsy, and it is the case that if non-headache migraine symptoms are accompanied by seizures, a seizure disorder could be the correct diagnosis, while acephalgic migraine would be incorrect.

While strong headache may not be a problem with acephalgic migraine, the other symptoms can prove disorientating and uncomfortable. Once a person has been diagnosed with this condition, doctors could make recommendations on best medicines to treat symptoms. These could include traditional migraine medicines but managing symptoms like nausea, with anti-emetics, might be all that is necessary to produce greater comfort. What doctors and patients decide to use is predicated on severity of episodes and patient need, and needs could change over time.

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