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Hemiplegic Migraine

About Hemiplegic Migraines

What Is A Hemiplegic Migraine?

Hemiplegic migraine is a rare form of migraine headache that is characterised by temporary paralysis or weakness on one side of the body (hemiplegia) during or before a migraine attack. It is considered a subtype of migraine with aura, which means it is preceded or accompanied by neurological symptoms known as aura which can include visual, sensory or speech/language issues.

Hemiplegic migraine is believed to be a result of abnormal brain activity and changes in blood flow in the brain and are directly connected to a specific genetic predisposition for this type of migraine.

 

Hemiplegic Migraine Diagnosis

How Do We Diagnose A Hemiplegic Migraine?

To diagnose hemiplegic migraine, healthcare professionals consider the individual’s medical history, symptoms, and family history of migraines. The diagnostic process may involve detailed medical history and neurological examination to assess motor function, reflexes, coordination, and sensory abilities. Other conditions that can cause similar symptoms, such as stroke, epilepsy, or other types of migraine, need to be ruled out through appropriate investigations.

Once it has been established after the first few episodes of hemiplegic migraine that it is not a stroke or any other sinister medical condition, it can alleviate the stress or concern about the condition to some degree but it is always a stressful event given the severity of the symptoms

Hemiplegic Migraine Symptoms

Aura symptoms

Aura symptoms which include visual disturbances, sensory changes, language difficulties, or disturbances in movement coordination.

Severe Headache

Paralysis Numbness

Temporary paralysis or weakness on one side of the body (hemiplegia). This can affect the face, arm, and leg on one side .

Sensory changes, such as tingling or numbness.

Nausea or Vomiting

Increased Sensitivity

Increased sensitivity to light (photophobia) and sound (phonophobia)

Treating Hemiplegic Migraines with the Watson Headache Approach 

Hemiplegic Migraine Treatment

The treatment of hemiplegic migraine focuses on managing symptoms and preventing future attacks. Treatment options may include migraine medications. However, caution must be exercised as certain medications may have contraindications in hemiplegic migraine due to the risk of vasoconstriction.

 Headache Practitioners assist in identifying triggers and making appropriate lifestyle modifications, such as managing stress, maintaining regular sleep patterns, and avoiding known triggers, can help reduce the frequency of hemiplegic migraine attacks.

Manual therapy treatment to desensitise the brainstem has been effective in managing the condition. Education and support in recognizing symptoms, managing attacks, guidance in coping strategies and seeking medical help when needed, is important.

For further reading to manage Hemiplegic migraine, read our blogs on Understanding Triggers,  Sleep hygiene and What causes migraine?

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Hemiplegic migraine – Frequently Asked Questions

What is a hemiplegic migraine?

A hemiplegic migraine is a rare and severe type of migraine that includes aura symptoms and temporary motor weakness or paralysis on one side of the body, resembling a stroke. The term “hemiplegic” refers to this motor weakness, which is usually fully reversible but can commonly last less than 72 hours but can persist for weeks. Hemiplegic migraines are classified into familial and sporadic types based on whether there is a family history of the condition.

Can hemiplegic migraines be treated?

Yes, hemiplegic migraines can be managed with a combination of medications, lifestyle adjustments, and manual therapy. Treatment focuses on preventing migraines, reducing their severity, and managing symptoms during an attack. Sydney Headache and Migraine Centre incorporates Watson Headache® Approach, focusing on addressing the underlying mechanical dysfunction in the upper neck which can contribute to your migraine presentation.

Are hemiplegic migraines serious?

Hemiplegic migraines are serious due to their stroke-like symptoms, which require prompt medical evaluation to rule out other conditions. The motor weakness associated with these migraines can be particularly concerning.

What causes hemiplegic migraines?

Hemiplegic migraines are believed to be caused by genetic mutations affecting the brain’s electrical and chemical signaling. In familial hemiplegic migraine (FHM), specific mutations in genes can lead to abnormal brain activity, resulting in the symptoms of a hemiplegic migraine. Sporadic hemiplegic migraine (SHM) occurs without a known family history but has similar symptoms. Epidemiological studies have shown that sporadic cases occur with approximately the same prevalence as familial cases.

How can hemiplegic migraines be treated?

Yes, hemiplegic migraines can be managed with a combination of medications, lifestyle adjustments, and manual therapy. Treatment focuses on preventing migraines, reducing their severity, and managing symptoms during an attack. Sydney Headache and Migraine Centre incorporates Watson Headache® Approach, focusing on addressing the underlying mechanical dysfunction in the upper neck which can contribute to your migraine presentation.

What does a hemiplegic migraines with aura mean?

A hemiplegic migraine with aura refers to a migraine that includes neurological symptoms such as visual disturbances, sensory changes, speech difficulties, and motor weakness. These aura symptoms are fully reversible, but the motor weakness can be particularly alarming and may last for up to 72 hours or longer.

Are hemiplegic migraines genetic?

Yes, hemiplegic migraines can be genetic. Familial hemiplegic migraine (FHM) is inherited and involves mutations in specific genes. Sporadic hemiplegic migraine (SHM) occurs without a family history, but in some cases, genetic mutations similar to those in FHM are present. Genetic testing can sometimes identify the specific mutation involved.

What triggers hemiplegic migraines?

Triggers for hemiplegic migraines include stress, certain foods (like chocolate and cheese), alcohol, changes in sleep patterns, hormonal fluctuations, and environmental factors such as bright lights or strong smells. In familial cases, mild head trauma can also trigger an attack.

How often do hemiplegic migraines occur?

The frequency of hemiplegic migraines varies widely among individuals and the pattern can be unpredictable. Some may experience them rarely, while others have more frequent attacks.

What can hemiplegic migraines affect?

Hemiplegic migraines can significantly impact daily life due to temporary paralysis or weakness, making it difficult to perform tasks like walking or speaking. The condition can also lead to anxiety and stress due to the fear of sudden attacks. Additionally, hemiplegic migraines may be mistaken for other neurological conditions, such as epilepsy, which can complicate diagnosis and treatment.

What causes migraine?

What causes migraine?

Migraines can be debilitating due to their moderate to severe intensity. If you experience a migraine, you may be out of action for at least a couple of hours or even up to three days! More than...

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