Hemiplegic Migraine

Migraine headaches can present in a variety of ways. They are episodic manifestations of a genetic neurological condition which results in significant pain located in the head and often preceded by an aura. An aura is a visual disturbance that can include temporary loss of vision, blinding lights or zigzag lines. A hemiplegic migraine is a rare form of a migraine disorder which is made even more confusing by having two variations of it: familial hemiplegic migraine and sporadic hemiplegic migraine.

Most of these rare types of hemiplegic migraines often begin in childhood and thankfully stop during the adult years. Interestingly, a hemiplegic migraine may not involve a headache at all but will always involve simple paralysis on one side of the body or the other. Someone who has a hemiplegic migraine will have trouble moving one side of their body.

The good news is that the symptoms are only temporary and are usually gone within 24 hours. Sometimes the symptoms can last for weeks but this is even less common in an already rare condition. If the individual gets a headache with the paralysis, the other symptoms can outlast the headache itself which is usually only short-lived.

It is important to note that the paralysis effects only one side of the body but the next attack can affect the other side of the body. There can be numbness, prickly feelings and an inability to move.

People who suffer from familial hemiplegic migraines have a close relative, either a sibling, parent or child, that carries the same genes which cause the symptoms. It is important to share a full family history with your neurologist in order to accurately diagnose the problem. Individuals who suffer from sporadic hemiplegic migraine have the same exact symptoms but there is no genetic connection found, and if there is any is known.

Diagnosis of any hemiplegic migraine can be difficult since the symptoms also indicate some type of vascular disease which can be stroke, epilepsy or other conditions. A neurologist should do a full neurological work up in a careful review of medical history in order to review out other causes and confirm the diagnosis.

People who suffer from hemiplegic migraine will experience episodes of prolonged aura (up to several days or weeks), paralysis on one side of the body, fever, impaired consciousness, headache, difficult coordination (ataxi), nausea and/or vomiting.

The treatment for person who have hemiplegic migraines can be exceptionally challenging. The symptoms are difficult to treat and those who experience them need to educate themselves both about the disease and the treatments. It is important to include a neurologist who has a successful track record in treatments of hemiplegic migraines.

The paralysis is simply a symptom of the problem that needs to be treated and there are others symptoms that also require treatment. Because of the connection between migraines and stroke there is a concern that certain medications may make individuals who have a heart problems even worse. The physician may recommend preventative medications such as calcium channel blockers, some antidepressants or beta-blockers all of which can be used successfully with people who have cardiac disease.

Because of the severity of the symptoms and the contraindication of using medications to stop the migraine it is important to work on prevention for individuals who have problems with hemiplegic migraines. Interestingly, genetic research has identified genes associated with familial hemiplegic migraines which affect calcium channels. This may explain why calcium channel blockers are sometimes especially effective in preventing the onset of an attack.

People who are at risk, or who have experienced an attack of hemiplegic migraine should wear a medical identification bracelet at all times because the attack can lead to impaired consciousness and an inability to speak. Medical identification can save valuable time in emergency situations and ensure that you receive the most accurate treatment protocols possible.

RESOURCES

Stanford Hospital and Clinics Headache Clinic: Headaches

International Headache Classification: Familial Hemiplegic Migraines

New England Journal of Medicine: The Clinical Spectrum of Familial Hemiplegic Migraine Associated with Mutations in Neuronal Calcium Channel

US National Library of Medicine: What is Familial Hemiplegic Migraine

Hemiplegic Migraine Foundation