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Hemiplegic Migraine: Types, Symptoms, Causes and Treatment

Hemiplegic Migraine: Types, Symptoms, Causes and Treatment

Some people confuse such migraines with a stroke because it is a rare form of migraine. One can develop neurological symptoms with this type of migraine, such as weakness on one side of the body. Several types of migraines and hemiplegia exist, including familial hemiplegic migraine (FHM) and sporadic hemiplegia migraine (SHM).

There are several types of hemiplegic migraine, and this article discusses their symptoms, causes, and treatment options.

Read: Rebound Headaches

What is hemiplegic migraine?

Hemiplegic migraine occurs in fewer than 1 percent of people suffering from migraines. An aura is a visual symptom that occurs before or during a migraine attack in this rare form of migraine.

Hemiplegic migraine is caused by:

  • Pain that is intense and throbbing
  • Nausea
  • Light and sound sensitivity

You may also feel numb, tingly, and paralyzed on one side of the body during treatment. Symptoms usually occur before headaches. The term “hemiplegia” means paralysis.

There are a few people who suffer from hemiplegic migraines, according to the National Headache Foundation. Migraine auras, which are visual symptoms, are flashing lights and zigzag patterns.

The condition is also characterized by sensory issues and difficulty speaking. Paralysis or weakness occurs as part of the aura in people who suffer from hemiplegic migraine.

Types of hemiplegic migraine

Hemiplegic migraine is divided into two types. Depending on your family history of migraines, you may have one of the following types:

  • Familial hemiplegic migraine (FHM): Family members of at least one close relative suffer from this condition. FHM affects 50 percent of your children if you have it.
  • Sporadic hemiplegic migraine (SHM): The condition affects people without a history of the illness in their families.

It is similar to the symptoms of a stroke in that a hemiplegic migraine episode causes confusion and trouble speaking. You can get the right diagnosis and treatment by visiting a neurologist or headache specialist.

Read: Ice Pick Headaches

What are the symptoms of hemiplegic migraine?

Some hemiplegic migraine symptoms include:

  • Face, arm, and leg weakness on one side of the body
  • Face or limb that is numb or tingly on one side
  • Other vision disturbances such as flashes of light or double vision (aura)
  • Slurred speech or trouble speaking
  • Drowsiness
  • Dizziness
  • Lack of coordination

Occasionally, hemiplegic migraine sufferers experience more severe symptoms, such as:

Memory loss can sometimes last months. Symptoms last for a few hours to a few days, but symptoms can also occur within hours or just a few days.

Short-term vs. long-term symptoms

The symptoms of hemiplegic migraine can continue for an hour or for several days. Motor symptoms usually go away after 72 hours, but in some cases, they can last weeks. Here are some examples:

  • Coordination problems
  • Changes in senses
  • Language changes
  • Involuntary eye movements

Read: Exercise Headaches

Causes

The two types of hemiplegic migraine are caused by different genetic defects. FHM may also be triggered by certain foods, stress, or a very minor head injury.

12–60% of migraineurs report that certain foods cause them to experience migraines. Common foods that cause migraines include:

  • Alcohol
  • Cheese
  • Chocolate

Alcohol can contribute to migraines by causing dehydration and sleep disturbance as well as increasing the risk of migraine.

The triggers of alcohol-induced migraines vary, but they typically include:

  • Red wine
  • Beer
  • Sparkling wine
  • Whiskey

Many cheeses and other foods contain a toxin known as tyramine, which can cause migraine attacks. Tyramine is present in foods such as:

  • Parmesan and gouda are aged cheeses
  • Many meats
  • Olives
  • Pickles
  • Chocolate
  • Nuts

Chocolate can also cause headaches because of its caffeine content. Also, hormonal changes and stress may lead to chocolate cravings.

Alternatively, irregular brain signals could be caused by chemical or electrical changes. This could affect how neural signals are processed by the brain.

Read: Hormonal Headaches

Diagnosis

The symptoms of hemiplegic migraine will be examined by a doctor to determine if the person has the disorder. Additionally, a family history will be considered.

It is necessary for the person to have experienced two episodes of hemiplegic migraine to receive a diagnosis.

This condition is characterized by both pain and paralysis. An individual suffering from this migraine must experience temporary motor weakness, vision problems, sensory problems, or speech issues in order to be diagnosed with the condition.

Moreover, they must also demonstrate these characteristics:

  • One or more neurological symptoms manifest over the course of 5 minutes or more
  • More than one symptom occurs at the same time
  • Motor symptoms last up to 72 hours, while non-motor symptoms last between 5 and 60 minutes each
  • Symptoms on only one side
  • Presence of visual, sensory, or motor symptoms with a headache within 1 hour

The doctor must exclude all other potential causes of the symptoms in order to make a correct hemiplegic migraine diagnosis. Transient ischemic attacks, strokes, and seizures are also possible causes.

What are the risk factors for hemiplegic migraine?

Such migraines attack typically starts as a child or young adult, according to the National Headache Foundation. It’s more likely to run in the family if you suffer from this type of headache.

It has been reported that hemiplegic migraines are 50 percent more likely to affect you if one of your parents suffers from them.

The risk of stroke is doubled if you have migraine with aura. Smoking and taking birth control pills can increase the risk even further. Nevertheless, stroke risks remain relatively low in general.

If you have a family history of hemiplegic migraine attacks, you may not be able to prevent them. Medications can be taken to reduce your headache frequency.

You can also help prevent this type of headache by avoiding factors that trigger headaches. People who get migraines less often as they age. However, migraines don’t always go away.

Read: Post-Traumatic Headache

What is the treatment for hemiplegic migraine?

There are many drugs that are used in the treatment of hemiplegic migraine that also work for classic migraines. Whether you require preventive or abortive treatment will depend on your doctor.

The aim of preventive migraine medications is to prevent migraine headaches from occurring before they occur, and abortive migraine medications help stop migraines in progress.

Preventive medications

The following medications may help prevent migraines:

  • Beta-blockers
  • OnabotulinumtoxinA (Botox)
  • CGRP antagonists
  • Anticonvulsants
  • Calcium channel blocker (verapamil, specifically)
  • Antidepressants

Abortive medications for acute attacks

There are several ways to abort acute (episodic) migraine attacks, including:

  • Magnesium, Toradol, and Reglan are intravenous (IV) medications.
  • Oral medications such as nonsteroidal anti-inflammatory drugs (NSAIDs), Ubrelvy and Nurtec ODTs.

Read: New Daily Persistent Headache

Summary

Hemiplegic migraine may manifest in both FHM and SHM forms. Genetic factors play a significant role in the development of symptoms of FHM, which can occur for a variety of reasons. Some of these reasons are stress and certain foods.

Patients with severe symptoms may need medications to treat their condition. It is possible to treat hemiplegic migraine.

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