Migraine Without Headache? by Dr. Suzanne Koven

Dr. Suzanne Koven November 30, 2011

A migraine without a headache? Isn't that kind of like fat-free half and half? Isn't a headache what a migraine is?

That's what my patient Lisa thought until just a few weeks ago. A busy mom in her 40s, Lisa has had migraines occasionally for many years. These have been very predictable. If she drinks too much coffee, or becomes dehydrated, she sees sparkly lights in her right field of vision and then gets horrific, throbbing pain in one side of her head, often with nausea and vomiting.

Not long ago, Lisa had symptoms that were, ultimately, also attributed to migraine, but which felt nothing like what she'd experienced before. First of all, she hadn't drunk too much coffee and she wasn't dehydrated. It started with some subtle and disturbing word-finding difficulties. She would say something to her husband, but the right words didn't come out. This happened a few times over a couple of days. Then, at work, she had the sensation of a shade being drawn over her right eye. In fact, she asked a co-worker if she'd turned the lights down. Then, her right shoulder began to tingle. At this point she came to the hospital and was admitted for a neurological evaluation. She was diagnosed with migraine--and she had no headache at all during the entire episode.

http://www.boston.com/lifestyle/health/blog/inpractice/2011/11/migraine_without_headache.html