Hemiplegic Migraine

Hemiplegic migraine is an alternate type of migraine involving weakness on one side of the body.

Symptoms are:

• Throbbing pain in the head prior to or after the onset of weakness
• Sometimes there will be no headache, just weakness
• Weakness on one side of the face, one arm or one leg
• Numbness and "pins and needles"
• Visual problems
• Confusion
• Speech difficulties
• Nausea and/or vomiting

• Sensitivity to light and sound
• Dizziness
• Sometimes temporary unconsciousness may occur

Not everyone has all the symptoms. Visual problems and speech difficulties only occur if the right side is affected.

Hemiplegic migraines have similar symptoms to a stroke but unlike stroke they will resolve within 24 hours and usually cause no lasting harm to the patient.

Diagnosis

The doctor will need to make sure your symptoms are not stroke, so in addition to taking a medical history he will order a CT scan or an MRI. He will also check your heart and make sure there aren’t any blood clots forming in the neck. If all of these results are negative for stroke or other conditions, you may be diagnosed with hemiplegic migraine.

What Causes Hemiplegic Migraine?

Hemiplegic migraine is caused by a neurotransmitter problem in the brain. The brain produces a specific protein which enables nerve cells to release neurotransmitters.

If the protein isn’t produced, then the nerves cannot release these neurotransmitters and the brain doesn’t receive the right messages. The majority of cases of hemiplegic migraine are genetically inherited and are caused by mutations in the CACNA1A, ATP1A2, and SCN1A genes.

Some cases of hemiplegic migraine are known as sporadic and they occur in the absence of any family history but in some cases are still caused by the same gene mutations. A genetic test is available.

Treatment

Triptans cannot be used as a treatment for hemiplegic migraine because they constrict vessels which could be dangerous with this type of migraine, but anti-inflammatory pain medications, anti-emetics to relief sickness or medications such as antidepressants or anticonvulsants can be used to treat the condition.

These can reduce the number of attacks and make them milder and easier to cope with. For very severe pain, intravenous magnesium sulphate may be given.
Treatment is usually necessary because of the severity of the symptoms.

Sources:

Hemiplegic Migraine, Medscape Reference. Web. 26 October 2011. http://emedicine.medscape.com/article/1142731-overview#aw2aab6b7

Hemiplegic Migraine Fact Sheet, The Migraine Trust. Web. 26 October 2011. http://www.migrainetrust.org/factsheet-hemiplegic-migraine-10913

Hemiplegic Migraine Headaches, WebMD. Web. 26 October 2011. http://www.webmd.com/migraines-headaches/hemiplegic-migraine-headaches-symptoms-causes-treatments?page=2

Joanna is a freelance health writer for The Mother magazine and Suite 101 with a column on infertility, http://infertility.suite101.com/. She is author of the book, 'Breast Milk: A Natural Immunisation,' and co-author of an educational resource on disabled parenting.

Reviewed October 26, 2011
by Michele Blacksberg RN
Edited by Jody Smith

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• Migraine