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HeadWay, Issue #032 -- Silent migraine
March 21, 2006
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In this month's issue:
Migraine support groups
Say what?! Cardiac migraine
My apologies -
Last month I offered you all a free gift in the HeadWay MailRoom, but I forgot to remind you where the HeadWay MailRoom is! Now there are two links for you. You can also access it by visiting the main HeadWay page, right here. Is there something you're concerned about, or want more info on? Drop by the HeadWay MailRoom, enter your password (nomoache) and leave your suggestions!
Silent MigrainePeople used to look at me funny when I told them I had a migraine but no headache. Let's face it, migraine and headache are so closely connected in people's minds that it's hard for people to imagine one without the other. But the truth is, a migraine without a headache can put you out of commission just the same as a migraine with a headache (not to belittle the horrible migraine headache!).
Silent migraines (and variously related problems) have had many names over the years, including acephalgic migraine, sans-migraine, migraine equivalent, eye migraine, visual migraine, ocular migraine and painless migraine. But the official name is migraine aura without headache.
Migraine aura without headache is a possible diagnosis if you're having off and on migraine symptoms but no headache. These symptoms usually include visual symptoms - bright, shimmering zig zags, shapes (geometric patterns in the eyes is common) or distortions are common visual auras. Also common in silent migraine is vertigo or dizziness. Other symptoms may include blind spots, difficulty speaking, weakness or numbness, double vision, or even amnesia. There are also specific types of migraine that do not involve headache but that usually aren't included in this category, such as abdominal migraine.
Diagnosing a silent migraine is tricky because it's important to rule out other disorders first. For example, some silent migraines mimic a minor stroke. Senator David Long in the USA recently had this problem - a diagnosis that evolved from stroke to migraine. It's important to talk to your doctor and have the patience to get the needed tests to rule out things like stroke, eye disease and seizure disorders.
Typically, a migraine aura will only last an hour. (There is a stage of migraine that can actually last a day or more, that is sometimes lumped in with "aura". However, visual disturbances like these are usually short lived) Often the problem is not severe enough to require medication. If it is, you want something fast-acting. You also want to be cautious about taking a medication that will be needed if a headache actually does strike. For this reason, the triptan class of drugs are often not used - they are reserved for early headache phases. (I got this suggestion from Dr Robert S. Kunkel, Consultant in the Headache Center at the Cleveland Clinic Foundation).
Commonly tried drugs include effervescent aspirin, calcium channel blockers, a beta-agonist inhalent, sublingual nitroglycerin, meclofenamate and naproxen sodium.
If you want to go into more detail, we now have a dedicated article on silent migraine. Or, you can learn more about migraine symptoms, and more specifically about types of migraine aura.
Migraine support groupsOne of our subscribers recently emailed about starting a migraine support group. I did a little research, and was actually surprised how few there are (considering the number of migraineurs there are in the world)! So I thought I'd include a paragraph here to see if anyone else out there was interested in starting a group.
There are a couple of ways you can go. First, you can start a group on your own. If you're the enterprising, organized kind this might be the thing for you. Or it might work well for you if you already have a friend or two you casually meet with, and just want to start something more official.
If you want to go through official channels or get more help with your support group, you could contact, in the USA, the National Headache Foundation or The American Council for Headache Education. The National Headache Foundation actually has groups around the world. In the UK the Migraine Action Association has groups as well.
If you know of a support group listing in your area, let me know and I may feature it in an up coming article on the website. Support groups really can be a valuable asset as you look for solutions. Positive, friendly, constructive and compassionate discussion is powerful - and who knows, you may find more ways you can help one another out. After all, that's what this website is all about.
Say what?! Cardiac migraineCardiac migraine was first suggested as a diagnosis in 1974. A patient basically has chest pain during a migraine attack, and the chest pain is not from the side effects of certain drugs. If a patient does get cardiac migraine, she would have to be sure to avoid drugs like triptans which could make matters worse.
Cardiac migraine, if it is a true type of migraine, is still being studied. Dr Michael Hoffmann reported on a study on stroke and chest pain in young people with migraine in Headache: The Journal of Head and Face Pain last month, concluding that cardiac migraine may be a distinct type of migraine requiring special treatment.
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