silent migranes(migraines)

I'm a 56 yr old white male, not a smoker or drinker or over weight, not on any meds and the only medical conditions is a slight heart mummer and gout which I've had for years and can be quite severe, and possibly irritable bowl syndrome. Back in the early 90's I had difficulty seeing and was seeing flashing lights with some blind spots. I had two CAT scans back to back and was told that I was having a "silent migrane (migraine)"; silent in that I had no pain. On rare occassions I have experienced that again. Just this month I have had 4. Should I be concerned with the frequency and has this ever been known to lead to a stroke?

[Neuro Forum]

Thanks for using the forum. I am happy to address your questions, and my answer will be based on the information you provided here. Please make sure you recognize that this forum is for educational purposes only, and it does not substitute for a formal office visit with your doctor.

Without the ability to examine you and obtain a full history, I can not tell you whether or not your symptoms are due to migrainous phenomena or otherwise, however I will try to provide you with some useful information.

It sounds like you have been diagnosed with ocular migraine, in which the visual aura of migraine occurs but a headache does not follow. This is not an uncommon disorder, and if the diagnosis is correct, the increase in frequency that you note may be related to an increase in usual migraine triggers such as lack of sleep, alcohol, hormonal changes, certain food exposures, etc.

While ocular migraine (silent migraine) does not lead to stroke, it is always important to make sure that neurologic symptoms are not misdiagnosed. Distinguishing whether or not your symptoms are TIAs, or transient ischemic attacks (what are commonly termed "mini-strokes) is important. TIAs are due to a transient decrease in blood flow to a part of the brain. The symptoms that occur depend on which area of the brain is not receiving blood.

Differentiating TIA from migraine is not always easy. Certain features can however be helpful. If the episodes are stereotyped, meaning they are very similar each time they occur, last around the same amount, etc, that makes them more likely to be migrainous. However, the distinction may be difficult to make, and I recommend that you be evaluated by a neurologist since it sounds like you received the diagnosis several years ago, if you have not been evaluated since then, particularly if the frequent episodes you are having lately are different from the prior ones. The reason I say this is that TIAs are a harbingers of stroke.

Thank you for using the forum, I hope you find this information useful, good luck.