Hemiplegic migraine is a rare, severe form of migraine with aura that may run in families. This condition causes temporary paralysis or weakness on one side of the body before or during a headache. Familial hemiplegic migraine (FHM) can be traced back in the family history and has been linked to specific genetic mutations. Sporadic hemiplegic migraine (SHM) shares symptoms with FHM but lacks the familial connection and genetic mutation. Because the symptoms of hemiplegic headache mimic those of other conditions, only a headache specialist can diagnose it properly. Count on the highly skilled, knowledgeable physicians at the Diamond Headache Clinic for accurate diagnosis and treatment of this rare headache type.
What Are the Symptoms of Hemiplegic Migrane?
SHM and FHM share these symptoms:
- Prolonged migraine aura episodes that last up to several days or weeks and include reversible hemiplegia (motor weakness/paralysis on one side of the body) and at least one of the following:
- Reversible visual symptoms such as seeing flickering lights and spots or loss of vision
- Reversible sensory symptoms such as tingling or numbness
- Reversible speech difficulties
- Symptoms of meningitis without the actual illness and inflammation
- Impaired consciousness (ranging from confusion to coma)
- Headache that may start prior to the hemiplegia or be absent
- Ataxia (loss of muscle coordination)
- Hemiplegia that may come on suddenly and be mistaken for a stroke
- Nausea and/or vomiting
- Sensitivity to light and/or sound
- For FHM: at least one close relative who has had attacks with these symptoms
How Is Hemiplegic Migraine Diagnosed?
A complete exam, including family history and a full neurological workup, is required. What makes the diagnosis of hemiplegic migraine extremely challenging is that its symptoms are so similar to those of vascular disease, stroke or epilepsy. A highly skilled headache doctor, like the ones at the Diamond Headache Clinic, must rule out those conditions before making an accurate diagnosis. A family history of FHM makes the diagnosis of that variant much easier. at least.
What Are the Hemiplegic Migraine Treatment Options?
Many of the abortive and pain relief drugs commonly prescribed for other migraine attacks, such as triptans and ergotamines, are contraindicated for hemiplegic headache. Safe drug treatment options include NSAIDs, antiemetics (for nausea and vomiting) and narcotic analgesics.
Because the symptoms are so severe and the use of abortive pain medications is inadvisable, your physician may prescribe a preventive regimen to treat your hemiplegic headache condition. Calcium channel blockers have been proven especially effective in preventing FHM.
A note of caution from the doctors at the Diamond Headache Clinic: Since an attack may be accompanied by impaired consciousness and the inability to speak, migraineurs diagnosed with hemiplegic migraine should wear a medical identification item. In an emergency, this step can ave valuable time and ensure that you receive the proper treatment.