Hemiplegic migraine 

• Hemiplegic migraine is a rare type of migraine that causes muscle weakness on one side of the body.
• Hemiplegic migraine causes are often genetic.
• Preventative treatment for hemiplegic migraine exists and consists of medication and lifestyle alterations.

Hemiplegic migraine is a rare condition. Besides severe headaches and other aura symptoms, it typically causes muscle weakness on one side of the body. These symptoms can be very debilitating and can resemble the symptoms of stroke, which is why it’s essential to receive a diagnosis and get started on a treatment plan as soon as possible. In this guide by Ada’s medical team, you will find more information on hemiplegic migraine, its symptoms, diagnosis, and treatment options. 

Hemiplegic migraine is a rare subtype of migraine with an aura. It’s characterized by the presence of an aura, which is usually limited to visual disturbances. However, with hemiplegic migraine, the aura can also include weakness of the muscles, changes to the way you feel things, or difficulty speaking. Attacks of hemiplegic migraine only occur in 0.01% of the population and often start in the teenage years. 1

Hemiplegic migraine symptoms often include the typical symptoms of an aura, such as: 2 1

• Visual disturbances such as seeing zigzag lines, black spots or flashing lights
• Feeling numbness or a tingling feeling
• Difficulty speaking and understanding others
• Dizziness

In addition to these aura symptoms, you can also experience: 2

• A temporary weakness on one side of your body. This weakness often starts in the hands and then moves up to the arm and the face.  
• Not feeling anything in certain parts of your body 
• Hearing loss or hearing a ringing sound in the ears
• Confusion
• Fever

These symptoms are often accompanied by a headache. In some cases, the headache can also occur after the aura symptoms, and in other cases, it may not occur at all.

Hemiplegic migraine is the result of certain channels in your brain not working properly. There are 2 types of hemiplegic migraine with different causes: 1

1. Familial hemiplegic migraine: a type of migraine that runs in the family and is caused by a mutation in your genes. 
2. Sporadic hemiplegic migraine: a type of migraine that happens to someone who doesn’t have any relatives with hemiplegic migraine.

Some situations may trigger hemiplegic migraine attacks: 1

• Stress
• Changes to your sleep pattern 
• Strong emotions
• Doing physical exercise
• Head injury

The symptoms of hemiplegic migraine can last anywhere between a few hours and a few weeks. The symptoms can appear suddenly or develop gradually over 20 to 30 minutes.

In order to diagnose hemiplegic migraine, your healthcare provider will ask you questions about your symptoms, your medical history, and your family history. Additional imaging may be necessary to rule out other possible causes of your symptoms. Some imaging techniques that may be used are CT, MRI, and EEG.

Hemiplegic migraine treatment depends on your situation and the type of hemiplegic migraine you’re experiencing. It’s important to seek advice from a medical specialist. Some hemiplegic migraine medication may be recommended to you, such as: 1 3

• NSAIDs
• Antiemetics
• Ketamine

Triptans and ergotamines are usually not recommended for this type of migraine, as they may increase the risk of stroke. 

Preventing attacks of hemiplegic migraine relies on a combination of lifestyle changes and avoiding triggers. Behavioral changes that are recommended for preventing migraine attacks include: 4

• Developing techniques to manage and reduce stress, such as deep breathing exercises and regular physical activity
• Keeping a diary to identify migraine triggers, such as exposure to strong smells, which can then be avoided if possible
• Sleeping well and establishing a consistent sleep cycle 
• Sleeping or lying down in a dark room can also help you during a migraine episode
• Staying hydrated, by drinking water and other non-alcoholic, non-caffeinated beverages throughout the day
• Establishing regular meal times and adopting a healthy, balanced diet
• Devising a new medication plan with the healthcare provider if any medications that a person takes regularly are thought to be causing the headaches
• Following a safe weight-loss program is recommended, for obese people affected by migraine headaches
• Taking preventative medication or supplements as recommended by your healthcare provider

On rare occasions, you can experience a severe attack of hemiplegic migraine. A severe attack may result in serious complications, such as: 1

• Mental health issues such as posttraumatic stress disorder
• Permanent brain injury
• Brain infarct 
• Decline in mental capabilities
• Coma
• Death

Hemiplegic migraine is a rare disorder that’s characterized by changes to the way you feel things and a weakness of your muscles on one side of the body. Attacks may be very debilitating, so receiving the correct diagnosis and following a treatment plan as recommended by a specialist is of high importance. 

Q: What is hemiplegic migraine? 
A: Hemiplegic migraine is a rare type of migraine with aura. It is characterized by weakness on one side of the body, changes to your consciousness and ability to communicate, and changes in how you feel things. 

Q: How rare is hemiplegic migraine? 
A: Hemiplegic migraine is a rare condition that only occurs in 0.01% of the population. 

Q: How serious are hemiplegic migraines? 
A: In some cases, hemiplegic migraines may require hospitalization. Severe attacks may even result in permanent brain injury, coma, or death. It’s crucial to receive a diagnosis as soon as possible so that you can start with preventative treatment. 

Q: Is a hemiplegic migraine a mini-stroke? 
A: The symptoms of hemiplegic migraine may resemble those of a stroke. However, they’re two separate conditions that are not the same.