About 70-75% of migraines are migraines without aura (standard), which have typical migraine symptoms including throbbing headache, nausea, vomiting, sensitivity to light (photophobia), and sound (phonophobia). However, migraine is a spectrum, and there are different types. It can cause symptoms.
Hemiplegic migraine is a rare type of migraine. One of the most important symptoms of this very uncommon but essential type of migraine is weakness on one side of the body. It can mimic a stroke’s symptoms and be confused with it, making it difficult to diagnose.
Like other types of migraines, hemiplegic migraines cause:
These symptoms begin before the headache. “Hemiplegia” means paralysis.
Aura also includes other sensory and speech problems. In people with hemiplegic migraine, weakness or paralysis occurs as part of the aura.
There are two types of hemiplegic migraine. The type you have is based on your family history of migraines:
It affects at least two close relatives in the family. If you have FHM, each of your children has a 50 percent chance of inheriting it.
It affects people who do not have a family history of this disease.
If there is a history of this type of migraine in the patient’s family, it is called familial diplegic migraine. (familial Hemiplegic Migraine) This disease is inherited from parents through genetics, and if the patient’s family history is adverse, it is called sporadic hemiplegic migraine (S parodic Hemiplegic migraine). This type of migraine is caused by a mutation A gene happens.
Many times, this type of migraine starts in childhood.
Paralytic migraines cause symptoms such as confusion and slurred speech that are similar to those of a stroke.
Visiting a neurologist or headache specialist for tests can help you with the correct diagnosis and treatment.
Symptoms of hemiplegic migraine can include:
Hemiplegia can cause:
One of the most common causes of hemiparesis is stroke. The severity of muscle weakness you experience can depend on the size and location of the stroke. Stroke in utero is the most common cause of hemiplegia in children.
People with this type of migraine rarely have more severe symptoms, including:
Symptoms may last from a few hours to a few days. Memory loss can sometimes last for months.
Many medications used to treat typical migraines are also effective for hemiplegic migraines. Your doctor may prescribe both a preventative medicine and a stopping medicine.
It is caused by changes (mutation) in genes. Several genes are associated with this type of migraine, including:
Genes contain instructions for making proteins that help nerve cells communicate. Mutations in these genes affect the release of brain chemicals called neurotransmitters.
When these genes are mutated, communication between specific nerve cells is interrupted. This issue can lead to severe headaches and visual disturbances.
In FHM, gene changes occur in family members. In SHM, gene changes occur spontaneously.
Note: The image is provided for professionals. Ordinary people ignore it.
Doctors diagnose hemiplegic or hemiplegic migraine based on their symptoms.
You have this type of headache if you have at least two migraine attacks with aura, weakness, and visual, speech, or language symptoms. These symptoms should go away after the headache improves.
Diagnosing hemiparalytic migraine is more complex than other diseases, such as stroke or mild stroke (transient ischemic attack). Its symptoms can also resemble MS (Multiple Sclerosis) or seizures.
To rule out diseases with similar symptoms, the doctor performs tests such as the following:
which uses X-rays to create images of the internal elements of your body.
which uses strong magnets and radio waves to create images of the internal elements of your body.
which measures the electrical activity of your brain.
which uses sound waves to create an image of your heart.
If one or more of your family members have this type of migraine, you can get genetic testing.
However, most people with familial or hemiplegic migraine will not test positive. Researchers have yet to find all the genes associated with this disease.
Hemiplegic or hemiplegic migraine attacks often begin in childhood or adulthood. If this type of headache runs in your family, you will likely develop it.
According to the Stroke Association, if one of your parents has a paralytic migraine, there is a 50 percent chance that you will also get one.
If hemiplegic headaches run in your family, you may be unable to prevent them. However, you can use medications to reduce the number of headaches you have.
Another way to prevent these migraine attacks is to avoid the factors that cause headaches.
Some people’s migraine attacks stop with age. However, in other people, this disease does not disappear.
According to the Stroke Association, having a migraine and aura can double the risk of some types of stroke.
If you smoke or use birth control pills, your risk of stroke increases, but the overall risk is still shallow.
Doctors disagree on how to treat hemiplegic migraine.
Your doctor may prescribe medications to prevent type of migraines and their onset, relieve your symptoms, and discuss your best treatment options.
There is much debate as to whether other migraine medications are effective for this type, and there is evidence that triptans, beta-blockers, and ergotamine derivatives may lead to ischemia. (less blood reaching an area of the body) in patients to treat migraine hemiplegia.
CGRP inhibitors are a new class of preventive medications for treating migraines, but studies show that this treatment may not be effective for hemiplegic migraines.
A hemiplegic migraine is rare, with symptoms similar to stroke and seizures. Like all migraines, this is accompanied by severe headaches, nausea, and aversion to light and sound.
In this type of migraine, the symptoms are temporary weakness, numbness, tingling and paralysis on one side of the body simultaneously as the headache or shortly before the occurrence. These symptoms are gradually created in the body and disappear entirely after the end of the migraine attack. The gradualness, movement of symptoms and complete removal of symptoms are the points of difference between the symptoms of hemiplegic migraine and stroke.
Dr. Majid Zohrabi started treating his patients in Dubai in 2022 and continues his activities in private medical centers in the UAE.