Silent Migraine & Visual Aura Without Headache: Kaleidoscope Vision, Zigzag Lines & Blind Spots

[00:00]

What if the migraine pain never comes?

[00:03]

Welcome to Migraine Heroes, a podcast for anyone living with migraine and wondering

[00:08]

why nothing has fully worked yet.

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I'm Diane Ducarme.

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Over the past 7 years, I've helped hundreds of people living with migraine.

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What I've learned?

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No two migraine stories are exactly the same, and none of them are simple.

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That is why, in this podcast, we explore migraine from many different angles.

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Food, hormones, stress, sleep, the nervous system, emotions, and much more, through the

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lens of both modern science and traditional Chinese medicine.

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A quick note before we start.

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What we talk about here is educational.

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For anything related to diagnosis or medication, please keep working with your doctor.

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Now take a breath, and let's dive in.

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In this episode, you will learn how a migraine can produce very real neurological symptoms,

[00:57]

even when there is absolutely no headache, and what scientists believe is happening inside

[01:02]

the brain when that occurs.

[01:05]

How to recognize the characteristic rhythm of migraine aura, while also understanding

[01:09]

the warning signs that mean you should never simply assume, oh, this is my migraine.

[01:15]

And how traditional Chinese medicine interprets a nervous system that suddenly produces visual,

[01:21]

sensory, or language disturbances, and what that perspective might teach us about regulation,

[01:26]

rhythm, and the conditions surrounding an attack.

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Stay with me till the end, because at the end of this episode, you will have a simple

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way to observe your next episode more clearly, what happened, how it developed, how long

[01:40]

it lasted, and what is happening in your body before it began.

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Okay, so imagine you're sitting at your computer, and suddenly noticing a tiny, tiny shimmering

[01:53]

patch in your vision, and you blink, still there, and then it starts to expand.

[02:00]

And perhaps it turns into a zigzag, a flashing line, or something that looks almost like

[02:07]

broken glass, or a kaleidoscope, and maybe part of the screen seems to disappear, maybe

[02:13]

there's a blind spot, a missing area in your vision, and everything suddenly looks strangely

[02:19]

pixelated.

[02:20]

You may find yourself rubbing your eyes, blinking again and again, and thinking, why can't I

[02:25]

see properly?

[02:27]

And then, perhaps, something else happens.

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Your fingers start tingling, the sensation moves slowly into your head, or up your arm,

[02:37]

or for a few minutes, you know exactly what you want to see, but simply you can't find

[02:42]

the right word.

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Literally, maybe another word comes out.

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And naturally, you wonder, what on earth is happening?

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And so you may even think, is this my eye?

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Is there something wrong with my vision?

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And then some of you might even think, am I having a stroke?

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So you're going to make an appointment with a doctor, it might be an optometrist, an ophthalmologist,

[03:01]

and they're going to examine your eyes, and tell you that everything looks normal.

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And you're really thinking to yourself, oh my god, you know, my vision, clearly not fine,

[03:09]

what do you mean that my vision is completely normal?

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And then someone might say, you may have had a migraine.

[03:18]

And your immediate response might be, hey, a migraine?

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That can't be, I had no headache, there was just no headache.

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And if someone connects the dots for you, you may eventually hear the words, migraine

[03:28]

aura without headache, what many people call a silent migraine.

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And suddenly, this very strange experience starts to have a name.

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So what exactly is a silent migraine?

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So a silent migraine is a popular term, rather than the preferred medical term.

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What people usually mean by it is a migraine aura without headache.

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And the International Classification of Headache Disorders, the third edition, recognizes a

[03:56]

condition called typical aura without headache.

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Now, in this condition, a person develops the neurological symptoms characteristic of

[04:04]

a typical migraine aura, but no headache accompanies the aura or follows it within

[04:10]

the next hour.

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And look, I really want to acknowledge the words typical here, as nothing feels quite

[04:15]

typical in that quite scary experience.

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But it tells us something very important, migraine, is that migraine is not simply a

[04:23]

headache disorder.

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That's a misconception a lot of people have.

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If you do have migraine with pain for years and decades, you know this is far from being

[04:32]

the case.

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But if you have silent migraine, this is probably a whole new territory for you.

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So head pain is actually one possible expression of a much broader neurological process.

[04:43]

The brain can enter part of the migraine process without necessarily proceeding into the pain

[04:47]

phase.

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And that is why somebody can experience a very unmistakable migraine phenomenon while

[04:53]

their head does not hurt at all.

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So I want to talk a little bit about what an aura actually feels like, so that you're

[05:01]

certain, right?

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If you're at home, you're certain this is what I've been experiencing.

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Aura is going to consist of temporary and fully reversible neurological symptoms.

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So for typical aura, these most often are going to involve vision, sensation, or language.

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And visual symptoms are by far the most common.

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So you may see flashing lights, that's a sign, or shimmering lights.

[05:23]

You may see zigzag, sparkling areas, blind spots, or parts of your vision that simply

[05:29]

seems to disappear.

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People often describe it in much more everyday language, like looking through a broken glass,

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or like a kaleidoscope, a TV static, or heatwaves on a road, or a glitch on a screen, or like

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someone erased part of the picture, the picture you're seeing.

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And so some describe a flashing crescent, or a jagged line that slowly grows and spreads

[05:53]

across the vision.

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So you see many different forms of expression.

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And there was a systematic review published in the Journal of Headache and Pain in 2025.

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It found that visual disturbances dominate the clinical picture of migraine aura.

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So sensory symptoms and language disturbances can occur as well, but in a much smaller proportion.

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Now sensory aura itself may feel like pins and needles, or sort of tingling that begins

[06:18]

in one place and then gradually travels.

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And a classic example is tingling beginning in the fingers and spreading through the hands

[06:25]

and arm, and sometimes reaching the face.

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Language aura can involve difficulty finding words, producing language, or understanding

[06:33]

language normally.

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One particularly useful study was published in Cephalalgia in 2016, and patients recorded

[06:40]

their auras prospectively in diaries.

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And visual symptoms occurred in 97% of the recorded auras.

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Sensory symptoms occurred in approximately a third, while language symptoms were much

[06:51]

less common.

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The median duration was around 30 minutes for visual symptoms, and 20 minutes for sensory

[06:56]

or language symptoms.

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But biology does not always read the textbook, as we all know, right?

[07:02]

Some auras are shorter, some are longer, and some involve symptoms appearing one after

[07:07]

another.

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Now why does it often spread so gradually?

[07:12]

That's one of the most fascinating parts of migraine biology.

[07:15]

The leading explanation for migraine aura involves something called, and we're going

[07:18]

to talk a lot about that concept so you can really keep it in your mind, what is called

[07:23]

cortical spreading depolarization.

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So imagine millions of brain cells maintaining delicate electrical and chemical gradients.

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And during cortical spreading depolarization, a slowly advancing wave of intense cellular

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depolarization travels across parts of your cerebral cortex.

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So behind that wave comes a temporary suppression of normal electrical activity.

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So the phenomenon moves slowly across the surface of your cortex, and because different

[07:53]

areas of the cortex perform different jobs.

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So this may explain one of migraine aura's most characteristic features, is that it evolves.

[08:02]

Something appears, it moves, it expands.

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One symptom may give way to another, and then eventually the brain's normal function returns.

[08:10]

That gradual progression is often quite different from the classic description of a vascular

[08:15]

event in which neurological function is suddenly lost all at once.

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Very different.

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But there's an extremely important qualification here.

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You cannot safely diagnose the cause of a new neurological symptom based solely on whether

[08:28]

it appeared gradually or suddenly.

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So stroke, transient ischemic attack, seizure, retinal disease, and other neurological disorders

[08:35]

can sometimes resemble migraine aura, while migraine aura can occasionally behave in atypical

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ways.

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And we're going to talk about that later.

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So why is there no headache?

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And so now we arrive to that strange part.

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And so if the migraine process has begun, why does your head not hurt?

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And look, we work with people who massively suffer from migraine and are bedridden because

[08:58]

of pain every single day.

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So don't get me wrong, you know, you don't wish it comes with pain in addition, right?

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But it's important to understand why.

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The most accurate answer so far is science does not completely know.

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So the neurological events that are responsible for aura and the biological process responsible

[09:16]

for migraine, head pain, they overlap, but they're not identical.

[09:20]

So migraine pain is going to involve activation of networks that include the trigeminal sensory

[09:26]

system and the structures around the brain, chemical messengers and pain processing pathways

[09:31]

that become involved.

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The cortical spreading depolarization can influence these systems and laboratory evidence

[09:39]

suggests pathways through which it could help initiate pain.

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But aura does not inevitably produce a headache.

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In fact, the existence of migraine aura without headache is powerful evidence that the aura

[09:51]

mechanism and the pain mechanism can be separated.

[09:54]

There was a 2025 scientific discussion by researchers that examined the relationship

[09:58]

between aura and migraine headache and emphasized precisely this point.

[10:02]

Although spreading depolarization is strongly linked to aura, the clinical relationship

[10:08]

between aura and subsequent head pain is considerably more complicated than a simple

[10:13]

aura causes headache.

[10:14]

Think of it less like one domino knocking down the next one and more several interconnected

[10:20]

neurological systems whose activity frequently overlaps, but does not always do so.

[10:26]

And so your brain may generate the aura and the pain network may simply never cross the

[10:31]

threshold required to produce the headache.

[10:33]

It does not make the episode imaginary, not at all.

[10:36]

It does not make it less migraine and simply means pain was not the final expression of

[10:42]

that particular attack.

[10:43]

Because we also serve people who have migraine aura without headache and migraine aura with

[10:51]

headache, so different types of attack for a single person, that's also possible.

[10:55]

And migraine itself, it may begin before the aura.

[10:58]

So another misconception is that the migraine begins the instant you see flashing lights,

[11:02]

right?

[11:03]

Modern migraine research suggests that the story can begin earlier.

[11:06]

So some people experience changes in fatigue, in concentration, mood, appetite, neck sensation,

[11:11]

light sensitivity, sound sensitivity, or yawning before the more obvious part of the attack

[11:16]

begins.

[11:16]

And so research published in the Journal of Headache and Pain in 2023 reviewed brain imaging

[11:21]

evidence suggesting that migraine involves changing activity across the brain system

[11:25]

even before the conventional headache phase.

[11:28]

So it gives us a much richer way to understand migraine.

[11:31]

So instead of saying migraine equals headache, you think migraine is a changing brain state.

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Headache can be one part of that state.

[11:40]

Aura can be another.

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And occasionally aura occurs without the pain phase at all.

[11:45]

So is silent migraine dangerous?

[11:47]

And a typical migraine aura itself is generally reversible.

[11:51]

But, but, and this is something I often tell people, you cannot always predict when an

[11:56]

aura is going to happen.

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You cannot choose the moment.

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It may happen while you're sitting safely at home, but it could also happen while you're

[12:03]

driving, crossing a busy street, cooking, or taking care of your children.

[12:07]

And that is important because the danger is not necessarily the aura itself.

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The danger can come from what you're doing when the aura begins.

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Imagine you're driving your children somewhere and suddenly a blind spot appears.

[12:17]

Part of the road seems to disappear from your vision.

[12:20]

You see shimmering zigzags, flashing lights, or that strange kaleidoscope effect spreading

[12:24]

across your visual field.

[12:25]

Even if you know that the episode will probably pass, your ability to drive safely may be

[12:30]

impaired in that specific moment, right?

[12:33]

Then someone else is driving on the road and someone else is maybe making mistakes with

[12:36]

their phone.

[12:37]

So when we say there is no headache, so perhaps it's not a big problem, I really want to

[12:41]

challenge that idea.

[12:42]

So no pain does not mean no impact.

[12:45]

A silent migraine can still interfere with your vision, with your sensation, with your

[12:48]

speech, and ultimately your ability to safely perform whatever activity you happen to be

[12:53]

doing when it arrives.

[12:54]

And because you cannot simply schedule an aura, recurring episodes deserve to be addressed,

[12:59]

particularly if they affect activities where suddenly losing part of your vision could

[13:02]

put somebody else or yourself at risk.

[13:05]

But this is also where responsible migraine education matters enormously.

[13:10]

A neurological symptom should not automatically be labeled migraine simply because you have

[13:15]

migraine.

[13:15]

So the International Headache Society specifically points out that diagnosing aura without headache

[13:21]

can be more difficult because there is no accompanying headache to help identify the

[13:26]

migraine pattern.

[13:27]

Other conditions, so particularly transient ischemic attack, sometimes need to be excluded.

[13:32]

So this becomes especially important when the experience is new, if it's new for you,

[13:36]

if it's different from your normal pattern, if it's unusually abrupt, unusually prolonged

[13:40]

or persistent.

[13:41]

And if you experience sudden weakness or facial drooping, inability to speak normally, persistent

[13:47]

loss of vision, severe imbalance, confusion or loss of consciousness or another new neurological

[13:53]

deficit, it's important, really, really important to seek a proper medical assessment and not

[13:58]

assume necessarily it is a migraine.

[14:01]

So the same applies when an aura-like phenomenon appears for the first time later in life or

[14:07]

when it changes substantially from a long-established pattern.

[14:10]

And again, the idea is always to reassure oneself, always to know what is happening,

[14:15]

both from a diagnosis perspective and then what to do in order to prevent them that comes

[14:20]

later, that comes next.

[14:22]

There was a 2024 study published in Headache, the journal of head and face pain, and it

[14:27]

examined people with migraine with aura who also experienced ischemic stroke and they

[14:31]

found that new or changed neurological symptoms were important warning clues.

[14:36]

Now let me help you a bit further, how to distinguish the patterns.

[14:40]

So there's no single blood test that says, yes, this was migraine aura.

[14:44]

Much of the diagnosis is going to come from the story of the event.

[14:49]

What happened first?

[14:50]

Was the symptom positive, such as seeing flashing lights or feeling tingling?

[14:55]

Or was something simply lost, such as a vision or sensation?

[14:59]

Did the symptoms spread?

[15:01]

And if it spread, how quickly?

[15:03]

Did one symptom follow another?

[15:05]

How long did each symptom last?

[15:06]

Was everything completely reversible?

[15:08]

And has the same pattern happened before?

[15:11]

And so research is going to demonstrate why detailed timing can be so useful.

[15:16]

Our symptoms have characteristic patterns, but also considerable variability, which means

[15:21]

that careful observation is far more helpful than simply remembering, oh, something really

[15:26]

weird happened in my vision.

[15:27]

So that's why keeping a diary can be so, so helpful.

[15:30]

There's also another reason an aura may last 20 or 30 minutes, but during those 20 minutes,

[15:37]

you're frightened.

[15:38]

Your perception is changing and therefore your perception of time changes.

[15:42]

And after remembering exactly whether something took two minutes, 10 minutes or 40 minutes

[15:47]

can be remarkably difficult.

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So writing down creates a much clearer neurological history.

[15:52]

And so this is something you get completely free on the Migraine Heroes app.

[15:56]

So the Migraine Heroes app is that app with the green background and the head with the

[15:59]

love heart inside.

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Just by doing your daily check-in, what's called the daily check-in, the app is going

[16:04]

to build the report for you.

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So in the app, you can explore it as a dynamic dashboard with graphs, adjusting the time

[16:10]

periods to see what you want.

[16:12]

And when you're ready to bring it to your doctor, you can download it as a PDF and it

[16:17]

laid out clearly with your pain pattern, with your medication, other symptoms and your cycle

[16:21]

dates along them.

[16:22]

If that's something you want to track or that is important for you to track, it's easy

[16:26]

to print or send and easy for your doctor to read through.

[16:29]

Now, what about treatment?

[16:31]

And so this is an area where science still has significant gaps because the aura often

[16:35]

resolves before an oral medication would have time to take effect.

[16:39]

And so treating an isolated aura in the moment, it can be just challenging.

[16:43]

And so Migraine Aura Without Headache was reviewed in Current Pain and Headache Reports

[16:47]

in 2018.

[16:49]

The shortage of clinical trials specifically targeting people who experience aura without

[16:52]

headache was noted.

[16:53]

And then again, in 2025, there was a systematic review and reached just a similar conclusion.

[16:59]

So compared with the enormous amount of research devoted to migraine headache, there is still

[17:03]

limited evidence for therapies specifically targeting aura itself.

[17:07]

Now, it's a nice segue into the East as it may give us more information about all of

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that.

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So I want to change language completely, not from English to Chinese, but from the language

[17:19]

of neurons, electrical gradients, corticals, spreading depolarization and ion channels

[17:25]

to another language, one that has been used for thousands of years to ask a very practical

[17:29]

question.

[17:30]

If this keeps happening to someone, what can we actually do to make it happen less?

[17:35]

Okay, very basic question.

[17:36]

So imagine you back then, it's 1000 or 2000 years ago, and there's just no MRI, no magnetic

[17:44]

resonance.

[17:44]

Imagine there is no neurologist, there is no migraine medication, there's no pharmaceutical

[17:50]

laboratory waiting for you.

[17:52]

And yet the problem is still there and still needs to be managed.

[17:57]

So this is where I think Eastern medicine becomes incredibly interesting because traditional

[18:01]

Chinese medicine had to develop an entire system of observation and intervention.

[18:05]

And so one of the first things traditional Chinese medicine would notice about the aura

[18:09]

is quite obvious, it's like the eyes are involved.

[18:11]

And when they say the eyes, they always pair the eyes and the vision.

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And in traditional Chinese medicine, the eyes and the vision have a particularly strong

[18:21]

relationship with what is called the liver system.

[18:23]

They call it gan in Chinese.

[18:25]

And so classical Chinese medical texts describe the liver having a close functional relationship

[18:31]

with the eyes and the vision.

[18:33]

And now when I say liver, I need to be really clear here.

[18:36]

Traditional Chinese medicine is not necessarily saying that your anatomical liver is diseased

[18:41]

because you see a zigzag.

[18:43]

That's not what it means.

[18:44]

The traditional liver system is a much broader concept.

[18:47]

So in traditional Chinese medicine, the liver system, so gan, when they say that one word,

[18:52]

that one character, is going to include your anatomical liver and your anatomical gallbladder.

[19:00]

But it's going to extend its functions to blood, tendons, ligaments, eyes, nails, menstrual

[19:07]

and reproductive system, and areas traversed by the liver and gallbladder channels, such

[19:12]

as your pelvis, your ribs, your temples, and the top of your head.

[19:16]

And I find those connections absolutely fascinating and absolutely useful and absolutely

[19:22]

actionable because it means you can observe all of that circuit.

[19:26]

That's what we do.

[19:27]

So when you download the Migraine Heroes app, so the green one with the yellow love heart

[19:33]

in the brain, it's going to ask you a set of questions.

[19:35]

And those questions are to understand, okay, among all of your systems, which system needs

[19:41]

the most support?

[19:42]

And what is your primary pattern?

[19:44]

Where to start the work to remove the problem?

[19:46]

And yeah, to remove, to manage, to mitigate the problem.

[19:50]

And so even outside Chinese medicine, human beings have always looked at the eyes as clues

[19:55]

to what's happening inside the body.

[19:56]

So if you notice your friend has their eyes red, injected with blood, or if you notice

[20:01]

your other friend has their eyes, the white of their eyes, really yellow, or when you

[20:06]

notice someone's really exhausted, the eyes look just, you know, really dark and tired

[20:10]

or puffy.

[20:11]

Intuitively, you understand that the eyes reflect what's happening elsewhere in the

[20:17]

body.

[20:17]

And now you need to imagine people doing that for thousands of years, over millions and

[20:21]

billions of people.

[20:21]

And so traditional Chinese medicine is going to take that observation so much further.

[20:26]

When the visual symptoms appear, they ask, is the liver system adequately nourished?

[20:32]

Is there too much upward movement?

[20:34]

Is there tension?

[20:36]

Is there heat?

[20:37]

So heat is a proxy for inflammation.

[20:39]

Is there wind?

[20:40]

Wind is a proxy for too much internal movement in the wrong direction.

[20:44]

Is there insufficient blood or yin to anchor the system?

[20:48]

And suddenly the question is no longer simply, what do I do when the flashing lights arrive?

[20:52]

But it becomes, what conditions are making my system more likely to produce them?

[20:57]

And so that's a much more actionable question.

[21:01]

Now let's pause here for a moment, because I'd like you to check in with yourself.

[21:06]

Just answer quietly in your head.

[21:09]

In the days leading up to an episode, do your eyes feel dry, tired, or strained?

[21:16]

Do your episodes tend to show up after short nights, or after a stretch of stress?

[21:23]

And around an episode, would you say you feel more tense and irritable,

[21:28]

or more depleted with very little energy left?

[21:32]

Now two people can see exactly the same zigzag and need very different things.

[21:37]

For some, the work is releasing that tension and upward pressure.

[21:41]

For others, it's about nourishing and restoring the systems well before the next aura arrives.

[21:47]

Now what you've just noticed are clues to your margarine pattern,

[21:51]

and that's what the Margarine Hero's Method is built around.

[21:54]

We look at your margarine in the way a practitioner would.

[21:57]

Where do you feel it?

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What comes with it?

[22:00]

What's going around it?

[22:01]

And how do you feel during it?

[22:03]

And in the app, it only takes a few steps before you get a first look at your own pattern.

[22:08]

It won't replace your doctor for anything new or unusual,

[22:12]

but it might help you find those missing pieces of your margarine puzzle.

[22:17]

And so that's why I love the West and the East,

[22:20]

because you see most of the time they really don't contradict each other.

[22:23]

But at the end of the day, we need pragmatism.

[22:26]

You know, we need to get to destination.

[22:28]

We need to get people better.

[22:29]

And so at the end of the day, we need to have people feel a lot better.

[22:32]

And that can't come from knowledge alone.

[22:34]

So this brings us to another central idea, which is an idea of nourishment.

[22:39]

And so in traditional Chinese medicine, blood means more than blood measured in a lab.

[22:45]

Blood represents nourishment and the body's capacity to support and anchor tissues and functions.

[22:51]

And then there's yin.

[22:52]

And you can think of yin very broadly as the cooling, the nourishing,

[22:56]

the restorative side of physiology.

[22:58]

And traditional Chinese medicine might say,

[23:00]

this person is consuming more than they're restoring.

[23:03]

There's just not enough nourishment, not enough recovery, not enough yin,

[23:06]

not enough blood supporting the system.

[23:09]

And when that foundation becomes weaker, the system may become easier to disturb.

[23:13]

And so that immediately gives us things to work on,

[23:16]

not after the aura, but before the aura.

[23:20]

And so these are really useful concepts.

[23:22]

I remember, you know, starting my lessons of traditional Chinese medicine.

[23:25]

This was 2011.

[23:27]

And I found it really esoteric.

[23:29]

I found it was really yin yang, the seasons.

[23:32]

I found, wow, this is just really high level.

[23:34]

But then once you have wins and once you start to transform something inside of you,

[23:39]

you're like, wow, this is actually really powerful.

[23:40]

Let me try to understand it more.

[23:42]

And I find it's just always much easier to enter Eastern medicine from

[23:46]

a place of benefiting your system than from the theory itself.

[23:50]

And so when we started working with people with migraine,

[23:53]

our job was practical from the onset.

[23:55]

It's like, how do we prevent these attacks?

[23:57]

And how do we help people manage them better?

[23:59]

That's the sole goal of why we're here.

[24:01]

And I became really obsessed with understanding,

[24:03]

OK, what are we actually changing when we're managing these,

[24:05]

quote unquote, small miracles or changes?

[24:08]

What are we doing?

[24:09]

So I took a neuroscience class at Harvard X.

[24:11]

This was two years ago.

[24:13]

And I was really keen after the class of traditional Chinese medicine to also

[24:17]

understand the Western point of view of it all.

[24:20]

And so one of the things that stayed with me from studying neuroscience at Harvard X

[24:24]

is that the brain is never simply on or off.

[24:27]

Its activity is going to depend on a constant balance between excitation and inhibition.

[24:33]

And so signals that encourage neurons to fire and signals that restrain them.

[24:38]

And vision itself is another beautiful example of this complexity.

[24:42]

So light enters through the eye.

[24:44]

But what we experience as seeing is produced through an entire different pathway,

[24:48]

a visual pathway from the retina and optic nerve through the thalamus

[24:52]

and ultimately to the visual cortex at the back of the brain.

[24:55]

And so even there, the visual cortex does not work in isolation.

[24:59]

It belongs to a much larger network of interconnected brain regions

[25:03]

that constantly influence one another.

[25:05]

And this is where I find it interesting as a parallel with traditional Chinese medicine,

[25:08]

TCM also rarely treats the symptoms belonging to one isolated structure.

[25:12]

The eyes and the vision, for example, are traditionally connected with the liver system.

[25:16]

But the liver itself is understood as part of a larger network

[25:19]

involving blood and yin, yang, qi and other organ systems.

[25:24]

And I'm not suggesting that the liver system is the visual cortex

[25:27]

or that yin and yang are simply excitation and inhibition.

[25:30]

They are fundamentally different models.

[25:32]

But both ways of thinking invite us to move beyond the isolated symptom

[25:37]

and ask a much broader question of what network is this symptom emerging from

[25:41]

and what has shifted in the balance of that network.

[25:44]

And so silent migraine is a particularly striking example

[25:46]

because the visual disturbance we experience at the eyes

[25:50]

may actually originate much further upstream

[25:53]

within the changing activity of the brain itself.

[25:57]

And that is why in my first example,

[25:59]

I told the ophthalmologist or the optometrist are going to say your eyes are fine

[26:03]

because they are problem manifests in the eye.

[26:06]

That's a symptom challenge or the imbalance is inside the activity of the brain itself.

[26:11]

And look, of course, it's quite sophisticated.

[26:13]

But for me, it has helped put words and frameworks around a question

[26:17]

I've carried for years.

[26:18]

And why is it so difficult to understand something like migraine through a single lens?

[26:22]

And in many ways, Western medicine has become extraordinarily good

[26:25]

at isolating mechanisms, structures and extremes of possibility,

[26:30]

identifying the molecule, the pathway, the nerve, the lesion.

[26:33]

And each medicine has traditionally been much more concerned

[26:36]

about health versus disease and the balance,

[26:39]

the relationship and the way the whole body functions together

[26:43]

when it is well.

[26:44]

And when it comes to silent migraine and migraine more broadly,

[26:47]

I think we are standing right at the intersection

[26:49]

of those two ways of seeing the body.

[26:51]

It's almost impossible to capture the whole experience

[26:54]

through a purely Western model.

[26:55]

But I also would not want to understand it through a purely Eastern one.

[26:58]

My hope is that bringing the two together

[27:00]

sheds a bit more light on what may be happening.

[27:03]

Because ultimately, understanding the rationality of your body,

[27:07]

why it may be responding the way it is,

[27:09]

and the story those symptoms are telling,

[27:11]

is, I believe, one of the very first steps towards really lasting relief.

[27:17]

That's all for today.

[27:18]

I hope this episode added another piece to your migraine puzzle.

[27:22]

If you'd like to apply what we've discussed to your own life,

[27:25]

you can find us by searching Migraine Heroes

[27:28]

in the App Store or Google Play.

[27:30]

Look for the green icon with the love heart in the brain.

[27:34]

Migraine is complex, but it's not random.

[27:37]

And every step forward brings us closer to lasting relief.

[27:40]

Your body has a story to tell.

[27:42]

Let's keep listening.

[27:43]

I will be back with you soon.