Hemiplegic Migraines - What are they?

Migraines can present in a multitude of ways. But how is a hemiplegic migraine different than a "regular" migraine that many patients are diagnosed with? According to the American Migraine Foundation, "a Hemiplegic Migraine is a rare form of migraine where people experience weakness on one side of their body (hemiplegia) in addition to the migraine headache attack. The weakness is a form of migraine aura and occurs with other forms of typical migraine aura like changes in vision, speech or sensation."

Are they genetic?

There isn't too much research to support either way, as hemiplegic migraines are pretty rare. The two most common forms of hemiplegic migraines are Familial Hemiplegic migraine and sporadic hemiplegic migraine. In familial hemiplegic migraines, they tend to run in the family, or at least one family member experiences these types of migraines. In sporadic hemiplegic migraine, it is only apparent in one individual family member.

As I previously talked about in my spinal tap article, there are certain procedures that need to be performed before a diagnosis can be fully confirmed. Patients will likely undergo a series of medications in addition to a full neurological workup. This will likely include imaging of the brain and head as well as ruling out other infections or abnormalities (like I described in my spinal tap experience) in order to rule out other causes. All of these, in addition to other work-ups your specialist may ask for and look at your medical history and any hospitalization may help confirm a diagnosis of hemiplegic migraines.

What are some of the symptoms of an attack?

  • Weakness or paralysis to one side of the body (hemi = half, plegia = weakness/paralysis)
  • Headache
  • Tingling, numbness in limbs, fingertips, feet, neck
  • Aura, vision changes, spots, visual field disruptions
  • Fevers
  • Aphasia (trouble speaking)
  • Nausea and vomiting
  • Sensitivity to light, touch or sound

The symptoms can last for hours to days, or rarely weeks, but most resolve completely. According to the Department of Health and Human Services, "Affected people may also experience neurologic symptoms such as confusion, drowsiness, impaired consciousness, coma, psychosis, and/or memory loss." Can you understand why this can mimic a stroke and can be very scary?

Are there "aftershock" headaches?

Yes, there can be for me, personally, I usually have the paralysis and weakness, numbing and stabbing/tingling before the onset of my migraines. I do not get a headache every single episode I have - that is important to note, as each patient experiences something different. It's also important to note that each episode isn't the same. You can begin to experience new symptoms with any episode, which can be incredibly scary and difficult to communicate to strangers if you are somewhere in public and unable to communicate what is going on. Hemiplegic migraines can be very scary to experience and also to witness. The best thing you can do for a loved one when you know they are experiencing symptoms is to get them a chair or let them sit/lay down in the most comfortable area until the paralysis and numbness subsides.

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