Hemiplegic migraine is an uncommon type of migraine that is mistaken for a stroke by some persons. A person suffering from this form of migraine may also experience neurological symptoms such as weakness on one side of the body.
There are two types of hemiplegic migraine: familial hemiplegic migraine (FHM) and sporadic hemiplegic migraine (SHM) (SHM).
The symptoms, causes, and treatment options for both types of hemiplegic migraine are discussed in this article.
Causes
Both kinds of hemiplegic migraine can be caused by genetic abnormalities. Certain meals, stress, or a slight head injury can all be triggers for FHM.
Certain meals are said to be migraine triggers for 12–60% of migraine sufferers. Foods that frequently cause an issue include:
- chocolate
- cheese
- alcohol
Alcohol may cause migraine symptoms by increasing the risk of dehydration and disrupting sleep.
Although there are a variety of alcohol triggers, migraines are frequently experienced after consuming:
- sparkling wine
- whiskey
- red wine
- beer
Certain cheeses and other meals can also cause migraines due to high quantities of the chemical tyramine. Tyramine-high foods include the following:
- pickles
- chocolate
- nuts
- aged cheeses, such as gouda or parmesan
- many meats
- olives
Chocolate’s caffeine level may also contribute to headaches. Stress and hormonal changes may also play a role in triggering chocolate cravings.
Additional possibilities include the presence of erratic chemical and electrical brain impulses. These have an impact on the way the brain processes chemicals called neurotransmitters.
Types
The causes, symptoms, and risk factors for the two forms of hemiplegic migraine are slightly different. The parts that follow go over these in further depth.
FHM
This type of hemiplegic migraine appears in families where a genetic abnormality or mutation may exist. This type influences the communication between neurons and chemical neurotransmitters in the brain.
A person who has FHM as a result of a genetic component has a 50% chance of passing this genetic trait on to their children.
FHM symptoms are most commonly noticed in people and adolescents. Symptoms may lessen as you become older.
SHM
SHM patients frequently do not have family members who suffer from hemiplegic migraine.
However, the condition can still be caused by a genetic mutation, and it can sometimes be confused with FHM. This is due to the fact that a person with SHM may be the first in their family to be diagnosed. This does not, however, rule out the chance that they have a parent who carries the genetic characteristic but has never displayed symptoms.
Symptoms
Although symptoms differ from one individual to another, they may include:
- drowsiness
- memory loss
- change in consciousness
- sensitivity to light or sound
- psychosis
- numbness or tingling of the face or in an extremity, such as an arm or a leg
- speech difficulty
- headache
- unilateral body weakness in the face, arms, or legs
- visual disturbances, such as blind spots, light flashes, zigzags, or double vision
- motor weakness
- clumsiness or lack of coordination
- confusion
Some people have more severe symptoms. If this is the case, symptoms can include:
Short-term vs. long-term symptoms
Hemiplegic migraine people may experience neurological symptoms that last anywhere from an hour to several days. The majority of people’s motor symptoms will go away after 72 hours, but in certain situations, they may last for weeks. These signs and symptoms could include:
- language changes
- involuntary eye movements
- Diagnosis
- coordination difficulties
- sensory changes
A doctor will check the person and look at their symptoms to diagnose hemiplegic migraine. Their medical history will also be examined by the doctor.
A person must have experienced at least two hemiplegic migraine attacks to be diagnosed.
There are two parts to the definition of hemiplegic migraine. To begin, a person must be having transient symptoms of motor weakness, vision, senses, or speech in order to be diagnosed with hemiplegic migraine.
They must also possess at least two of the following characteristics:
- each individual non-motor symptom lasting for 5–60 minutes, and motor symptoms lasting for up to 72 hours
- the visual, sensory, or motor symptom accompanied or followed by a headache within 1 hour
- at least one symptom on one side only
- at least one neurological symptom that spreads gradually over 5 minutes or more
- two or more symptoms that occur in succession
The clinician must rule out all other possible causes of the symptoms before making an accurate hemiplegic migraine diagnosis. A transient ischemic attack, a stroke, or a seizure are all possible causes.
Treatment and prevention
The purpose of hemiplegic migraine treatment is to avoid and manage symptoms, however this is dependent on the severity of the symptoms.
Medication may be used as part of the treatment, such as:
- anti-seizure medications
- intravenous verapamil
- tricyclic antidepressants
- antinausea medications (antiemetics)
- nonsteroidal anti-inflammatory drugs
- calcium channel blockers
- beta-blockers
Doctors caution people with hemiplegic migraine not to use some drugs because of the risk of stroke. Triptans and ergotamines are examples of medicines that constrict blood vessels.
Conclusion
FHM and SHM are the two types of hemiplegic migraine.
Despite the fact that FHM is caused by a genetic factor and runs in families, a range of triggers can lead to the onset of symptoms. Certain foods and stress are examples of them.
Medications may be used to treat the condition, depending on the severity of a person’s symptoms. Hemiplegic migraine can be managed.
Sources:
- https://jnnp.bmj.com/content/jnnp/91/7/764.full.pdf
- https://rarediseases.info.nih.gov/diseases/10768/hemiplegic-migraine
- https://pubmed.ncbi.nlm.nih.gov/22644176/
- https://www.medicalnewstoday.com/articles/317545
- https://ichd-3.org/1-migraine/1-2-migraine-with-aura/1-2-3-hemiplegic-migraine/
- https://www.ncbi.nlm.nih.gov/books/NBK513302/
- https://americanmigrainefoundation.org/resource-library/alcohol-and-migraine/
- https://americanmigrainefoundation.org/resource-library/caffeine-and-migraine/
