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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.


This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.


  • mrst53
    9 months ago

    I get really cold, during my hemiplegic migraines. I also have the sensation that I am dragging my right foot. No one notices till I can’t speak well.

  • Mimi
    9 months ago

    Sporadic hemiplegic is one of the different types of migraines I have. Luckily, rarely comes…but when comes, it does strongly and scares me like no other. No way to differentiate it from a stroke as none has been the same …numbness, weakness, confusion, speech problems, vision spots, sensitivity to light/sound, my brain gets disconnected of my speech and motor skills in some way, confusion, etc. Not always get the headaches after the episode either. So i have been told to go to the ER to check me out anyway… Again I get them very rarely, maybe 3 times in a 20 year history of migraines which is enough as I have other types and get migraines very frequently. Hemiplegic was actually my very first migraine, and I was diagnosis quite early which helped a lot. Hope we learn more on how to get help and what is really going on inside our brains :()

  • #purpleproject moderator author
    9 months ago

    Hi Mimi! That’s great that you don’t have many of them in a year!! Can I ask if you are on a certain medication regimine that has been helping your frequency?

    I don’t always get the headaches afterwards either.. but when I do, they roar.

  • Mariaeugenia
    9 months ago

    Hello! I suffer form hemiplegic Migraines…the first time I had one, I went to ER and spend 7 days at the hospital…they thought it was a stroke….after the seven days and multiple exams, MRI etc etc, they couldn’t tell me what was happening….I ended with almost $50 thousand in hospital bills and no diagnosis.. A week later I visited a great neurologist who gave me the correct diagnosis: hemiplegic migraines….. Before and after every attack I can’t think properly..difficult to find the correct words..sometimes I lost my balance..the tingling comes…and I feel like I’m in a middle of a fog…I hope the cure can be found.

  • #purpleproject moderator author
    9 months ago

    My heart breaks reading your story, Maria. Your story sounds a lot like mine. The financial burden is just out of this world when trying to find a diagnosis.

    Be well,

  • Frosti
    9 months ago

    I have experienced this type of migraine but only 4-5X that I am aware. I loose vision in my right eye, speech is slurred, I cannot walk straight, I search for words when trying to talk, am nauseated, have a bad headache and lights drive me crazy. I worked in the medical field and 3 of the 5 times I experienced this I ended up in the ER because co-workers thought I was having a stroke. First 2 times I thought I was as well…other time I could not convince them that it was not a stoke and ended up in the ER again. They are very scary for the person experiencing the attack and for those around them.

  • #purpleproject moderator author
    9 months ago

    Extremely scary. I hid my symptoms from others for so long. I wish I could let people in and let them help instead of hiding my pain. I’m not sure people actually understand how scary it is to “almost” have a stroke every time we have these symptoms.

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