Hemiplegic Migraine is a rare form of Migraine disease, made more confusing by there being two variations: Familial Hemiplegic Migraine (FHM) and Sporadic Hemiplegic Migraine (SHM). Migraineurs with Hemiplegic Migraine should give special consideration to wearing some kind of medical identification at all times since an attack can lead to impaired consciousness and an inability to speak.
Causes of Hemiplegic Migraine
Hemiplegic migraines are often caused by an inherited gene, but they occur in people with no family history of migraines. Hemiplegic migraine may be autosomal dominant. In about 50% of these families, a chromosome defect may be found on chromosome 19 or on chromosome 1 and involves abnormal calcium channels.
Symptoms of Hemiplegic Migraine
Symptoms include temporary paralysis down one side of the body, which can last for several days. Other symptoms include vertigo or difficulty walking, double vision or blindness, hearing impairment, numbness around the mouth leading to trouble speaking or swallowing.
Diagnosis/testing for Hemiplegic Migraine
The diagnosis of FHM rests on clinical findings and family history. The diagnostic criteria are:
1) fulfills criteria for migraine with aura;
2) aura includes some degree of hemiparesis and may be prolonged;
3) at least one first-degree relative (i.e., parent, sib, offspring) has identical attacks.
Treatment of hemiplegic migraine
There are two main challenges when it comes to treating hemiplegic migraine. First, the paralysis is simply one more symptom, probably among many others, that need to be treated. Second, because of the connection between migraine and stroke, and especially the similarities with headache and hemiplegic migraine and stroke symptoms, there is concern about certain medications that may make heart problems worse.