For some people, the worst thing about migraine is not pain - it's migraine nausea. The most debilitating, incapacitating symptom can be the nausea. Some don't get it at all, but those who do may find themselves feeling almost like they can't move.
Acephalgic migraine (also called acephalalgic migraine, migraine aura without headache, amigrainous migraine, isolated visual migraine and optical migraine) is a neurological syndrome. It is a relatively uncommon variant of migraine in which the patient may experience aura, nausea, photophobia, hemiparesis and other migraine symptoms but does not experience headache. While it is generally classified as an event fulfilling the conditions of migraine with aura with no (or minimal) headache, it is sometimes distinguished from visual-only migraine aura without headache, also called ocular migraine.
Acephalgic migraines can occur in individuals of any age. Though there are some individuals—more commonly male—who only experience acephalgic migraine, frequently patients also experience migraine with headache. Generally, the condition is more than twice as likely to occur in females than males. Although not listed as such in the International Classification of Headache Disorders, pediatric acephalgic migraines are listed along with other childhood periodic syndromes by W.A. Al-Twaijri and M.I. Shevell as "migraine equivalents", which can be good predictors of the future development of typical migraines. Individuals who experience acephalgic migraines in childhood are highly likely to develop typical migraines as they grow older. Among women, incidents of acephalgic migraine increase during perimenopause.
Migraine surgery is any surgical operation undertaken with the goal of reducing or preventing migraines. Innovative surgical techniques have been developed to help patients with migraine headaches. Migraines affect an estimated 10% of the worldwide population annually and cause significant loss of workdays and billions of dollars in productivity. It is well documented that migraine headaches cause significant disability, and reduce of quality of life that is as dire, if not worse than, debilitating chronic diseases. There have been major pharmacological advances for the treatment of migraine headaches, yet patients must still endure symptoms until the medications take effect. Furthermore, often they still experience a poor quality of life despite an aggressive regimen of pharmacotherapy. For these reasons, surgical solutions to migraines are actively being researched, particularly those involving the surgical cauterization of the superficial blood vessels of the scalp (the terminal branches of the external carotid artery), the removal of muscles in areas known as "trigger sites", and those involving the correction of a congenital heart defect. Despite the lack of evidence supporting the removal of muscles, there are over a dozen surgeons actively performing these operations in the US.