Hey! I'm hoping any of you guys with more experience with HM might be able to offer some insight. These migraines were the first neurological experience I had as a young teen, with an aura including one sided numbness and tingling, a visual lightshows, and aphasia. In early adulthood I found out I had an AVM (malformed blood vessel) on my brain that caused a seizure, and had surgery to have it removed. The avm was right by the part of my brain that controls my right side and speech, so the migraines made sense. It's been a few years since my surgery, and I'm still controlling my seizures with meds. My migraines have come on-and-off, and have been rare enough and mild enough that I didn't treat them separately. But the past few years my migraines have changed a bit. Instead of just numbness and tingling in my right arm, the sensations spreads with a ton of pain too, creeping from my fingers up to my shoulder, with the tingling spreading to my face. This week I had one with horrible aphasia, but not my usual visual aura. And the confusing part is, I've read a lot of people say that hemiplegic migraines can be one of the most painful kinds of migraines, and while I've had a few excruciating ones, it's generally been somewhat manageable with Excedrin, and the worst of the headache doesn't usually last more than 3 or 4 hours. Is it typical for the attacks to vary or present like that? Or should I explore the possibilities of a seizure again? The long, slow aura seems to make it so obviously a migraine, but lately I'm worried and confused. Any insight or ideas welcome! (And yes, I'm going to speak to my neuro, but I could use help understanding my own experiences to decide what my next best step is).