Hemiplegic migraine

It’s thought that migraine is one of the most common conditions in the world, affecting 1 in 7 people globally.

If you experience migraines you’ll know that they aren’t just a bad headache. A migraine can stop you from carrying out normal, everyday activities, and can cause numbness, pins and needles, nausea, and vomiting, and as well as visual disturbances.

In more rare cases, a migraine can cause temporary, mild paralysis on one side of your body. This is known as a hemiplegic migraine, and it can be really scary if you’ve never experienced it before. The good news is, symptoms normally pass within the space of a day.

What is a hemiplegic migraine?

A hemiplegic migraine is a rare type of migraine that causes weakness down one side of the body. 

The word “hemiplegic” is used to describe a condition that causes paralysis (“-plegic”) in just one half (“hemi”) of the body. One other cause of this kind of paralysis is a stroke, which is why people who experience a hemiplegic migraine may think their condition is far more serious than it is.

How rare is hemiplegic migraine?

Hemiplegic migraines are extremely rare, affecting 0.01% of the population compared to migraines which affect 15 to 20% of the population.

During a migraine attack you may experience throbbing pain, nausea and light sensitivity. Hemiplegic migraines also cause weakness down one side of the body which can affect your face, leg and arm. 

Hemiplegic migraine symptoms

The characteristic symptom of a hemiplegic migraine is weakness down one side of the body. This weakness can affect the face, arm and leg, and will usually last for several hours. In some cases the symptoms can persist for longer than a day, but this is rare.

It’s common for people who have hemiplegic migraines to experience aura symptoms. These may include:

• Vision disturbances (flashing lights, zigzag lines, blind spots)
• Numbness, tingling, and pins and needles
• Other symptoms include problems speaking and walking, confusion, and sensitivity to light and sound

Usually, a hemiplegic migraine will also be followed by a headache. For some people, the headache may come beforehand, or may not occur at all.

Hemiplegic migraine types

There are two different types of hemiplegic migraines based on your family history, which include: 

Familial hemiplegic migraine

The term “familial hemiplegic migraine” (FHM) is used when the condition affects multiple people in the same family, indicating an inherited genetic defect.

FHM can be diagnosed when two or more people in the family experience weakness down one side of the body when they get a migraine. It’s thought that about 50% of children who have one parent with hemiplegic migraine will develop the disease.

Sporadic hemiplegic migraine

The term “sporadic hemiplegic migraine” (SHM) is used when a person with this type of migraine doesn’t have any family members with the condition. The cause here is thought to be a “sporadic” rather than inherited genetic defect.

What causes hemiplegic migraine?

A hemiplegic migraine is thought to be caused by dysfunction in the brain, which affects how chemical messengers like serotonin are released.

Hemiplegic migraines are thought to be triggered by:

• Stress 
• Intense emotions
• Either too little or too much sleep
• Physical activity 
• Head trauma

Hemiplegic migraine treatment

It’s really important to get medical help when you experience a hemiplegic migraine. The main symptom – paralysis down one side of the body – could be a sign of something more serious that needs emergency treatment, like a stroke.

It’s likely that you’ll need specialist help to manage your hemiplegic migraines. You can get a referral to a migraine clinic from your GP, or sometimes from a hospital doctor or another type of healthcare professional.

A specialist will be able to recommend treatments that are suited to your condition, and will avoid prescribing medication that doesn’t work for hemiplegic migraines. As an example, triptans – a common treatment for other types of migraine – are not thought to be suitable for hemiplegic migraine during the aura phase.

Hemiplegic migraine diet

If certain foods are a trigger for your hemiplegic migraines you may want to follow a diet that eliminates or limits these foods. For example, people who experience migraines find that:

• Alcohol
• Caffeine
• MSG
• Sweeteners
• Chocolate
• Salty foods

If a certain diet would help your symptoms your doctor will discuss this alongside other treatment options. Keeping a headache relief diary can help you spot your triggers, download your copy here. 

Are hemiplegic migraines dangerous?

A hemiplegic migraine can be scary to experience especially if you’re having one for the first time. The symptoms of body weakness, speech difficulties and confusion are similar to a stroke which is why you should seek medical attention when experiencing these symptoms for the first time.

Unlike a stroke, where symptoms come on quickly, hemiplegic migraines attacks build gradually. If you regularly have hemiplegic migraines you should discuss any concerns you have with your doctor. 

Get help for migraines with LloydsPharmacy Online Doctor

If you’re experiencing the symptoms of a hemiplegic migraine, you should speak to your GP, as this is a complex and serious condition. 

If you’re experiencing an ordinary migraine without weakness down one side of the body, you may be suitable for treatment through Online Doctor. We can provide triptans (Sumatriptan and Rizatriptan), a standard medication for dealing with migraine pain, or Vydura (rimegepant) which can provide migraine relief and prevention. 

References

https://www.migrainetrust.org/about-migraine/migraine-what-is-it/facts-figures/
https://www.nhs.uk/conditions/migraine/
https://www.merriam-webster.com/dictionary/hemiplegia
https://www.migrainetrust.org/about-migraine/types-of-migraine/hemiplegic-migraine/
https://www.nationalmigrainecentre.org.uk/migraine-and-headaches/migraine-and-headache-factsheets/hemiplegic-migraine-an-overview/  
https://www.ncbi.nlm.nih.gov/books/NBK513302/
https://migrainetrust.org/news/hemiplegic-migraine-faqs/