Migraine aura without headache or silent migraine is an uncommon condition. The life-time prevalence of migraine headache aura without headache or silent migraine in any unselected population is reported to be only 0.95%.
Noiseless migraine occurs in a small but clinically related number of migraineurs the location where the entire process aborts before any headache occurs. If there is generally a comfortable migraine pattern when confronted with a normal neurological test, no further analytic testing is necessary. Overdue onset migraine complement presents in middle aged or older patients, and is a harmless occurrence. Looking at the dilemma from another perspective, among adult individuals suffering from migraine together with aura, approximately 40% have had about silent migraine or migraine feeling without headache.
Migraine headache equivalents can also occur in the pediatric and adolescent population without related headache. Silent migraine headaches features typical migraine headaches aura lasting 10 min. which is generally visual, and may consist of micropsia or metamorphopsia (the so-called “Alice inside Wonderland syndrome”).
Attacks without frustration may also alternate using episodes accompanied by head ache. But whereas headaches commonly begin in the very first three decades of life, silent migraine generally starts during or after middle age, becoming increasingly frequent together with advancing age. It features a male preponderance, as opposed to the well-described prevalence from the more common types of migraine headaches in women. Some people develop episodic neurologic dysfunction which resembles an aura-and could be migrainous in origin-for the first time once you hit 45.
Almost any nerve symptom can happen again in a migrainous pattern and yet be unaccompanied by headaches. Visual symptoms, such as scintillations, scotomas, and photopsias, are the most usual. Less frequently, patients make a complaint of repeated episodes of paresthesias of the face as well as hand, hemiparesis, dysphasia, or signs such as dysarthria and ataxia that indicate involvement in the brain stem. Others have repetitive vertiginous symptoms (benign re-current vertigo).
In the Eighties, Fisher described a large group of patients who appeared to have developed silent headaches or migraine with aura for the first time after age 45. They’d episodes of neurologic dysfunction that included scintillating scotomas, paresthesias, dysarthria, aphasia, brain come symptoms, and generator weakness.
However, coming from a practical point of view, detecting new-onset, silent migraine in the older individual are only able to be made after thorough and exhaustive tries have been made to leave out cerebral thrombosis embolism, arterial dissection, subclavian steal, angiitis, thrombocythemia, polycythemia, hyperviscosity syndromes, and epilepsy. Handful of neurologists would consider perish diagnosis unless the person had a history of battling without sequelae from almost, identical occurrences a duration of several years.
In sum, silent migraines or Acephalgie headaches occurs both in individuals with a well-established history of migraine and in individuals with a robust family history of migraine headache but who have never experienced more normal migraine with go pain.
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