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Hemiplegic Migraine

One rare kind of migraine is hemiplegic migraine. This type of migraine can occur randomly or it can run in families. When it occurs randomly, without a family link, it is called sporadic hemiplegic migraine. When more than one member of the family has this disorder it is called familial hemiplegic migraine.

Hemiplegic migraine occurs in roughly one in 10,000 people. Usually hemiplegic migraines start in childhood.

Hemiplegic migraine symptoms include:

  • Aura, both visual aura and sensory aura
  • Muscle weakness that goes away after the migraine attack, and often occurs on one side of body
  • Vision changes, such as seeing flickering lights, spots or lines
  • Loss of vision, partial or complete loss of eyesight
  • Difficulty speaking that goes away after the migraine attack
  • Head pain

The main symptom that distinguishes hemiplegic migraine from other types of migraine is the muscle weakness that completely disappears after the migraine attack ends. The motor or muscle weakness typically goes away after an hour and happens more often in the arms than in the legs. In fact, attacks of hemiplegic migraine tend to become less frequent as the migraine sufferer gets older.

To diagnose familial hemiplegic migraine – the only type of migraine scientifically confirmed to run in families – at least one person in the immediate family or other close relative must have the exact same type of migraine attacks.

Diagnosing hemiplegic migraine

Because muscle weakness, vision changes, difficulty speaking and head pain are also telltale signs of a stroke, the first time someone experiences these symptoms they must seek immediate medical attention. Some patients are also mistakenly diagnosed with epilepsy. Sporadic hemiplegic migraine is only diagnosed if the person experiences repeated attacks and stroke as well as transient ischemic attacks have been ruled out.

Treating hemiplegic migraine

The treatment for hemiplegic migraine is similar for the recommended treatment for migraines in general. First, the migraine triggers must be identified and avoided. Each person may have a different combination of triggers. It is very helpful if you keep a migraine journal that records your migraine symptoms, what time of day you experience them, what occurred before the symptoms began, how long they last and the severity. This will help you identify and later avoid your migraine triggers as well as accurately diagnose migraines. Like other types of migraine, sometimes migraine sufferers are treated only to stop an attack once it has started. If the attacks are severe, some receive prophylactic treatment regularly to avoid migraine attacks.


Written by: Otesa Miles | Revised by: Kristine Zerkowski | Last reviewed: August 2014.
Cortical spreading depression---Migraine: a complex genetic disorder; Lancet Neurology, Wessman, 2007