Presentation
Signs of a hemiplegic migraine attack are similar to what would be presented in a stroke that typically includes sudden severe headache on one side of the brain, weakness of half the body, ataxia and aphasia which can last for hours, days or weeks. [2 [en.wikipedia.org]
Cases: We present two siblings with hemiplegic migraine, depression, progressive spastic paraparesis, myelopathy, and spinal cord atrophy. One of the sisters presented with prolonged coma after a migraine episode. [journals.sagepub.com]
Individuals with pathogenic variants in CACNA1A typically present with cerebellar signs such as nystagmus, while patients with defects in ATP1A2 may present with epilepsy (Yabe et al. 2008; Russell and Ducros 2011; Deprez et al. 2008). [preventiongenetics.com]
Entire Body System
-
Weakness
Description: Migraine with aura including motor weakness. [ichd-3.org]
Hemiplegic Migraine is a rare form of migraine where the person experiences many of the usual migraine symptoms, but may also suffer from temporary numbness, weakness or even paralysis on one side of their body! [migraine.ie]
Signs of a hemiplegic migraine attack are similar to what would be presented in a stroke that typically includes sudden severe headache on one side of the brain, weakness of half the body, ataxia and aphasia which can last for hours, days or weeks. [2 [en.wikipedia.org]
The most significant criterion in diagnosing FHM is hemiparesis or weakness of a limb (Thomsen et al. 2002). [preventiongenetics.com]
-
Pain
Physiotherapy can also help with pain management. Lifestyle Modification : Lifestyle can be an important factor in treating or coping with Hemiplegic Migraine. [migraine.ie]
-
Fever
[…] including; Numbness or weakness on one side of the body (Hemiplegia) Once side of the face can fall which looks like a stroke Headache Visual disturbance and aura (sparkles, shimmers) Numbness or tingling in extremities Slurred speech or trouble speaking Fever [migraine.ie]
-
Unconsciousness
[…] side of the face can fall which looks like a stroke Headache Visual disturbance and aura (sparkles, shimmers) Numbness or tingling in extremities Slurred speech or trouble speaking Fever Confusion, brain fog and in extreme and very rare cases possible unconsciousness [migraine.ie]
-
Falling
People, who suffer from Hemiplegic migraine specifically, experience a whole gamut including; Numbness or weakness on one side of the body (Hemiplegia) Once side of the face can fall which looks like a stroke Headache Visual disturbance and aura (sparkles [migraine.ie]
Respiratoric
-
Cough
He had a 48‐hour hemiparesis triggered by a bout of coughing with hemoptysis, loss of consciousness, and severe hypoxia‐hypercapnia. [headachejournal.onlinelibrary.wiley.com]
-
Hemoptysis
He had a 48‐hour hemiparesis triggered by a bout of coughing with hemoptysis, loss of consciousness, and severe hypoxia‐hypercapnia. [headachejournal.onlinelibrary.wiley.com]
Gastrointestinal
-
Nausea
Acute medications used include the normal NSAIDs such as Ibuprofen or Diclofenac (Difene), along with an antiemetic (anti-nausea) medication such as Domperidone or Metoclopromide to ease the nausea, but also to aid in the faster absorption of other medication [migraine.ie]
Other common symptoms include nausea, vomiting, and/or extreme sensitivity to light or sound. Age of onset is variable, often occurring within the first or second decade of life, with attack frequency decreasing with age. [preventiongenetics.com]
-
Vomiting
[…] disturbance and aura (sparkles, shimmers) Numbness or tingling in extremities Slurred speech or trouble speaking Fever Confusion, brain fog and in extreme and very rare cases possible unconsciousness Ataxia – Muscles not working properly Nausea and/or vomiting [migraine.ie]
Other common symptoms include nausea, vomiting, and/or extreme sensitivity to light or sound. Age of onset is variable, often occurring within the first or second decade of life, with attack frequency decreasing with age. [preventiongenetics.com]
Eyes
-
Photopsia
Visual disturbances may occur in the form of blind spots (scotoma), flashing lights (photopsia), zigzag patterns (fortification spectra), and double vision (diplopia). Dysphasia usually develops in right-sided hemiplegia. [preventiongenetics.com]
-
Diplopia
Visual disturbances may occur in the form of blind spots (scotoma), flashing lights (photopsia), zigzag patterns (fortification spectra), and double vision (diplopia). Dysphasia usually develops in right-sided hemiplegia. [preventiongenetics.com]
Psychiatrical
-
Impulsivity
When a nerve impulse (electrical) of sufficient strength passes down from one nerve cell towards another, it opens a so-called ‘channel’ which acts like a ‘gate’. [migraine.ie]
-
Suggestibility
Brain SPECT hypoperfusion suggests a more extensive permanent neuronal loss in territories affected by aura. CF may be then a risk factor for hemiplegic migraine and stroke since bouts of coughing can facilitate brain hypoxia, triggering auras. [headachejournal.onlinelibrary.wiley.com]
Neurologic
-
Aura
Description: Migraine with aura including motor weakness. [ichd-3.org]
Brain SPECT hypoperfusion suggests a more extensive permanent neuronal loss in territories affected by aura. CF may be then a risk factor for hemiplegic migraine and stroke since bouts of coughing can facilitate brain hypoxia, triggering auras. [headachejournal.onlinelibrary.wiley.com]
May Published in Annals of neurology 1996 DOI: 10.1002/ana.410390115 Familial hemiplegic migraine (FHM) is an autosomal dominant disorder characterized by transient hemiplegia during the aura phase of a migraine attack. [semanticscholar.org]
Familial hemiplegic migraine is a rare autosomal dominant subtype of migraine with aura in which attacks are associated with hemiparesis. [journals.sagepub.com]
The neurological symptoms of FHM aura commonly include visual disturbance, sensory loss, and/or dysphasia that may last hours to days following the initial migraine. [preventiongenetics.com]
-
Stroke
Hemiplegic migraine can be one of the more difficult types of migraine to diagnose as many of the symptoms can mimic stroke, seizures or other conditions. [migraine.ie]
CF may be then a risk factor for hemiplegic migraine and stroke since bouts of coughing can facilitate brain hypoxia, triggering auras. [headachejournal.onlinelibrary.wiley.com]
Acetazolamide or standard drugs are often used to treat attacks, though those leading to vasoconstriction should be avoided due to the risk of stroke. [en.wikipedia.org]
-
Aphasia
The patient experiences bouts of coughing sometimes triggering SHM attacks with visual phosphenes, aphasia, right‐sided paresthesia, and hemiparesis. [headachejournal.onlinelibrary.wiley.com]
Signs of a hemiplegic migraine attack are similar to what would be presented in a stroke that typically includes sudden severe headache on one side of the brain, weakness of half the body, ataxia and aphasia which can last for hours, days or weeks. [2 [en.wikipedia.org]
-
Nystagmus
@article{Elliott1996FamilialHM, title {Familial hemiplegic migraine, nystagmus, and cerebellar atrophy.}, author {Michael A. Elliott and Stephen J. Peroutka and Simon Welch and Eugene F. [semanticscholar.org]
Individuals with pathogenic variants in CACNA1A typically present with cerebellar signs such as nystagmus, while patients with defects in ATP1A2 may present with epilepsy (Yabe et al. 2008; Russell and Ducros 2011; Deprez et al. 2008). [preventiongenetics.com]
-
Paresthesia
The patient experiences bouts of coughing sometimes triggering SHM attacks with visual phosphenes, aphasia, right‐sided paresthesia, and hemiparesis. [headachejournal.onlinelibrary.wiley.com]
Indications for Test The ideal test candidates for this Familial Hemiplegic Migraine (FHM) panel are individuals who experience hemiplegic migraine with aura involving the cerebral cortex or the brain stem, visual disturbances, paresthesia, and dysphasia [preventiongenetics.com]
Workup
Serum
-
Hypercapnia
He had a 48‐hour hemiparesis triggered by a bout of coughing with hemoptysis, loss of consciousness, and severe hypoxia‐hypercapnia. [headachejournal.onlinelibrary.wiley.com]
Treatment
Other Possible Treatments : Many people with migraine choose non-pharmaceutical methods of treatment and many of them can be used for Hemiplegic Migraine such as; Magnesium Coenzyme Q10 Vitamin B2 (Riboflavin) Feverfew Some other complementary treatments [migraine.ie]
Epidemiology
Epidemiology [ edit ] Migraine itself is a very common disorder, occurring in 15–20% of the population. [en.wikipedia.org]
Pathophysiology
SHM pathophysiology relies on cortical spreading depression (CSD), which might be responsible for ischemic brain infarction. [headachejournal.onlinelibrary.wiley.com]
Prevention
Hemiplegic migraine is generally treated with preventative medications, including; Calcium Channel Blockers – Verapamil (Isoptin), Flunarizine (Sibelium) Anticonvulsive Medication – Topiramate (Topamax) Antidepressants – Amitriptyline Beta Blockers such [migraine.ie]