Most people think of a migraine as excruciating pain, but a migraine episode is far more than pain. Migraines typically have four stages: pre-headache, aura, headache, and post-headache. Millions of people globally suffer from these full-blown, 4-stage migraines - but a minority experience painless episodes. So what are painless migraine episodes?



Technically, there is no such thing as a painless migraine. That is, if you go by the International Headache Society's (IHS) Guidelines for diagnosis and classification of headache disorders. Yet your physician may tell you that yours is a painless migraine. He or she may call it a painless, optical migraine.

What are painless migraine episodes?

The answer is in the question. A painless migraine is a migraine episode that begins with the typical pre-headache stage, progresses to the aura phase of a migraine attack, and then stops short. It skips the headache phase - the pain.

If you have a painless migraine, you have the visual symptoms of the aura and other symptoms of a migraine without the headache. Such a migraine would usually be termed a migraine with aura. A physician following the IHS guidelines would describe it as "acephalgic" - meaning "without headache."

Pre-headache - Phase #1

The pre-headache phase is sometimes referred to as the prodrome. This is where your painless migraine episode begins. You may enter this stage hours or even days before what would normally be recognized as a migraine episode.

Recognizing the prodrome can be very helpful to you, since it is a warning. It is telling you that migraine changes are beginning to take place. How do you know? You may have some or all of the following symptoms.

* constipation

* diarrhea

* depression

* fatigue

* food cravings

* frequent urination

* irritability

* neck muscle stiffness

Aura - Phase #2

As your painless migraine progresses, you enter phase #2 - the aura. This familiar phase lasts less than an hour in most cases, but can be terrifying. Some of the bizarre symptoms and effects of the aura are believed to have influenced Lewis Carroll as he wrote "Alice in Wonderland."

Most people think of aura as being only visual: zigzag lines, spots in front of your eyes, or flashing lights. They believe the aura phase affects only the eyes. This may explain the physician's term, "painless, optical migraine."

It is true that these are typical aura symptoms, but the aura phase has many symptoms, including:

* auditory hallucinations - you hear sounds that aren't there

* confusion in thinking - things aren't making sense

* decrease in your hearing ability

* difficult finding the words you want

* dizziness

* increased feel and touch - or reduced feel and touch

* olfactory hallucinations - you smell odors that aren't there

* partial paralysis

* sight loss - partial or blurry vision

* tingling or numbness of your face

* visual hallucinations - you see sights that aren't there: flashing bright lights, wavy lines, spots, or zigzag lines

If you have a painless migraine, your episode stops here. You do not go on to experience the throbbing pain.

Other terms used for a painless migraine include "migraine equivalent," "silent migraine," and "sans-migraine." Even if you think yours is a painless migraine, consult with your health-care provider to be sure. Other serious conditions may be present.

Painless migraine episodes can be prevented in some cases, while others can be treated effectively. Turn your next painless migraine into a non-event.