• Migraines

Hemiplegic Migraine​: Causes, Symptoms, and Treatment

Hemiplegic migraine is a rare and complex type of migraine that’s known for its unique neurological symptoms. Because these episodes can look a lot like a stroke, they’re often hard to diagnose, which adds to the stress of managing such a challenging condition. There are two types – familial and sporadic – each with its own causes but similar patterns of symptoms that come and go. While it’s uncommon, hemiplegic migraines can be serious, so understanding what sets it apart is key to getting the right diagnosis and care. Because this type of migraine shares similarities with other neurological conditions, it can be misdiagnosed, delaying proper treatment.

In this article, we’ll outline the causes, symptoms, and potential treatment options of hemiplegic migraines to help you manage your health and improve your well-being. 

What is a Hemiplegic Migraine?

A hemiplegic migraine is a rare type of migraine that causes temporary paralysis or weakness on one side of the body, along with other neurological symptoms such as aura, visual disturbances, or difficulty speaking. These episodes are often accompanied by severe headaches, but in some cases, the paralysis can occur without a headache at all. Hemiplegic migraines stand apart from more common types of migraines due to their distinct and often disabling symptoms.

There are two forms of hemiplegic migraines: familial hemiplegic migraine (FHM) and sporadic hemiplegic migraine (SHM). Familial hemiplegic migraine is inherited, caused by genetic mutations passed down through families. Sporadic hemiplegic migraine occurs in individuals with no family history of the condition. Both forms share similar symptoms, but their underlying causes differ.

Hemiplegic migraines are episodic, meaning symptoms come and go rather than being constant. They fall within the broader category of migraine disorders but are distinguished by the presence of motor weakness, making them one of the most complex and unusual forms of migraine.

Causes of Hemiplegic Migraine

The causes of hemiplegic migraine vary depending on whether it’s familial or sporadic. In familial hemiplegic migraine, the condition is linked to specific genetic mutations passed down through families. These mutations affect the way certain brain cells communicate, making some individuals more prone to episodes. Sporadic hemiplegic migraine, on the other hand, occurs without a family history, and its exact cause is less clear, though it may also involve genetic factors or spontaneous mutations.

For both types, certain triggers can set off an episode. Common factors include stress, hormonal shifts, certain foods, and even changes in the weather. While FHM has a clearer genetic link, SHM highlights how complex and multifaceted the causes of hemiplegic migraine can be.

Symptoms of Hemiplegic Migraine

The symptoms of hemiplegic migraine can vary from person to person, but they typically include temporary one-sided paralysis or weakness, known as hemiplegia. This is often accompanied by aura, which may include visual disturbances like flashing lights or blind spots. During an episode, individuals may also experience a severe headache, along with heightened sensitivity to light and sound.

The progression of symptoms can vary, but the paralysis often comes on gradually and may last anywhere from a few minutes to several hours, typically resolving once the migraine episode subsides. It’s important to note that the symptoms of hemiplegic migraine can closely resemble those of a stroke, making prompt medical attention crucial for an accurate diagnosis and appropriate care. 

Is Hemiplegic Migraine Dangerous?

Hemiplegic migraine can be alarming due to its ability to mimic life-threatening conditions, like a stroke. The temporary paralysis and other neurological symptoms it causes often lead to significant concern, and rightly so. Prompt medical evaluation is essential to rule out more serious issues. 

While the episodes themselves are rarely dangerous, complications or misdiagnoses could pose risks, especially if treatment is delayed. 

Treatment for Hemiplegic Migraine

While there is currently no cure for hemiplegic migraine, there are treatment options available to help manage the condition and reduce the frequency and severity of episodes. Acute treatments focus on providing relief during an episode – including pain relief medications, anti-nausea treatments, and sometimes hospital monitoring if the symptoms are severe.

For long-term management, preventive measures are key. These may include medications to reduce the likelihood of future attacks, making lifestyle changes to avoid known triggers, and tracking symptoms to better understand individual patterns. Identifying personal triggers like stress, certain foods, or hormonal fluctuations can be particularly helpful in preventing episodes.

In familial hemiplegic migraine cases, genetic counseling may play an important role in understanding the condition's hereditary nature and helping families manage it more effectively. It's also essential for those who experience hemiplegic migraines to work closely with a specialist to develop a personalized care plan tailored to their specific needs and circumstances.

When to See a Doctor

If you experience symptoms like temporary paralysis, confusion, or severe headache with neurological signs, it’s crucial to seek immediate medical attention. These warning signs could indicate a hemiplegic migraine or something more serious – such as a stroke or seizure – so it’s important to rule out these conditions with the help of a healthcare professional. Early diagnosis and treatment of hemiplegic migraine can help manage symptoms more effectively, reduce the frequency of episodes, and improve your overall quality of life.

If you experience hemiplegic migraines, treatment typically involves seeking out a specialist who can provide in-person care to properly manage the condition. Since hemiplegic migraines are rare and complex, it’s important to receive a personalized treatment plan tailored to your specific needs. 

However, if you’re looking for non-urgent guidance on more common types of migraines, LifeMD may be able to assist. A licensed healthcare provider can offer advice on managing your condition and may prescribe medication if clinically appropriate.

Schedule an online appointment to get started. 

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