A young college student sits crumpled in the floor of her dorm room. She is supposed to be in class, but cannot even bring herself to get dressed. She began experiencing visual field disturbances, nausea, and light sensitivity – all classic symptoms of migraine aura. But the symptoms quickly became more severe, causing confusion, slurred speech, and paralysis on one half of her body. Her roommate returns to find her experiencing stroke-like symptoms and calls for an ambulance. Hours later, she reveals something shocking: She has been experiencing these symptoms since childhood – all caused by a rare form of migraine known as hemiplegic migraine.
About Hemiplegic Migraines
Hemiplegic migraine attacks are a highly uncommon sub-type of migraines with aura. Though few people ever experience one of these migraine episodes, those who do typically suffer from a severely debilitating migraine symptom that can last for several days. For hemiplegic migraineurs, it is the aura phase that is so incapacitating. The term hemiplegic itself refers to paralysis on only half of the body. Doctors diagnose the condition based on the migraine symptom experienced during aura, which must include non-permanent motor weakness accompanied by visual disturbances, sensory disruptions or dysphasic speech disturbance.
Read: Aphasia Migraine Symtpom: Losing The Ability to Speak, Read or Write
It’s important to remember that each person will experience a hemiplegic migraine differently. Symptoms are not always consistent from episode to episode. While some people will experience similar symptoms with each attack, others will have migraines with aura symptoms and headache pain that vary in intensity and duration.
Due to the rarity of hemiplegic migraines and their symptoms, the condition can go mis-diagnosed or mistaken for other medical conditions, such as stroke or epilepsy. Furthermore, migraines – including hemiplegic migraines – often present during early childhood (usually between the ages of 5 and 8). Fortunately, many cases of hemiplegic migraines subside in adulthood.
What Researchers Know About Hemiplegic Migraines
Because hemiplegic migraines are rare, little is known about why they occur. In fact, they are so uncommon that headache researchers in Denmark attempting to study the condition found only 147 people with confirmed cases of familial hemiplegic migraines out of more than 27,000 cases of reported headache sufferers.
What doctors and scientists have been able to pinpoint from their research is two different types of hemiplegic migraineurs – those with Familial Hemiplegic Migraines (FHM) and those with Sporadic Hemiplegic Migraines (SHM). Though they share the same symptoms, people with FHM have a family history of the condition linked to specific genetic mutations. Less frequently, migraineurs will present with SHM, which is a hemiplegic migraine disorder devoid of known related genetic mutations.
Research is ongoing to learn more about how hemiplegic migraines respond to internal and external stimuli. According to the National Institute of Neurological Disorders and Stroke, the connection between FHM genetic mutations and hemiplegic migraines is believed to be associated with heightened levels of glutamate and dysfunctional calcium regulation in the brain.
The complexities of FHM and SHM make them difficult for doctors to treat. Because hemiplegic migraines are simply an expression of an underlying neurological disorder, researchers are tasked with learning how to not only reduce migraine frequency, but also to manage the severe symptoms of hemiplegic migraines. Non-steroidal anti-inflammatory drugs, antiemetics, and narcotic analgesics are most frequently used for pain relief, and calcium channel blockers are used to prevent hemiplegic migraine episodes.
Doctors are reluctant to prescribe traditional migraine pain relief medications like triptans and ergotamines to FHM and SHM patients because their properties raise concerns about vascoconstriction and stroke. However, a 2007 study of the safety and efficacy of triptans for FHM and SHM patients showed a migraine symptom reduction without instances of stroke or heart attack. Though additional research is needed, it seems that triptans could prove to be both a safe and effective hemiplegic migraine treatment.
Have you been diagnosed with hemiplegic migraines? Share your story in the comment section below.
Image Source:
From 10-12 Feb, my college is hosting the fest and I’m all busy with covering events and participating in as I’m a photographer in my college
Exhausted, i was chilling with my friends at the end of the day also i was having a severe headache mainly on my left part of the the brain, specifically around the left eye
When suddenly, i my ears got numb, I couldn’t hear anything, everything blurred, my left body portion fainted and couldn’t move and feel my left hand and leg, my friends got hold of me. Then i went unconscious, they helped me to my dorm room and lay on the bed
After i regained consciousness, i felt really awkward and confused, my friends told me what happened after I fainted, after i lay down i was just lying there not moving a nerve and then I started panicking, still unconscious. My friends told that i was dead scared using my hands to protect myself from something crying and screaming they tried to wake me up rubbed my hands but nothing
They said when they holded my hand, i was crushing it very hard, i was very uncomfortable and scared of something it was something like sleep terrors
Even after I regained consciousness, I couldn’t control my left hand and legs, they were moving awkwardly in their own, my friend help calm me down and only after 30 minutes i was little bit normal
Since then i my headache hasn’t stopped it’s recurring all the time, i also felt unconscious 3 times since the incident but didn’t fainted and i feel I’ve less control over my left part
Way back in 1972 I had my first hemiplegic migraine; complete with numbness, loss of movement, loss of speech and control of my eyes. After that they were a 10-12 time a year issue. In between severe bouts, I had -migraines with aura and some numbness, tingling, loss of speech but no falling, no loss of consciousness or total loss of sensation or use. Always left sided.
I was admitted on a few occasions to the Montreal Neurological hospital – They were sure I was having strokes..Then I got pregnant. Still had migraines with aura and some speech disturbances and minor numbness but never a severe bout again. The last was in 1983.
Until last Monday.
On Friday I had a migraine, slight aura, bad headache. It lasted into Saturday and I had that after effects of THOR trying to beat his way out of my head on Sunday any time I bent over.
Monday I woke up felt great, My hubby was making coffee, and I walked behind him and Bang. my leg went dead, I hit the floor. Unconscious. Loss of speech, left side drooping, no sensation in my arm of leg. My husband saying look at me, look at me while lifting me off the floor, but my eyes only wanted to look as far right as possible.
Paramedics came – STROKE!!!
Into the hospital, all the stroke tests, carotid artery exams, CT scans, MRI, Brains scans, Hert montirs, feeling fine after a couple of hours, then the tooth aches set in. I ALWAYS get toothaches in all my molars after a migraine.
UofA hospital today..
It was a hemiplegic migraine and I am fine, but they are back.
Thank you for the great article
I experienced one full-blown hemiplegic migraine in 2002 (at 50 years old) and have had up to two auras annually (treated upon onset) with complete resolution within 30 minutes with Migranal spray. Original HM was initially believed to be stroke by emergency medicine MD but was accurately diagnosed in ER by a neurologist who happened to be head of the inpatient headache clinic.