Hemiplegic Migraine | Symptoms, Diagnosis and Treatment

Hemiplegic Migraine

This is an uncommon form of migraine with symptoms similar to those associated with stroke, especially the severe and acute weakness of the muscle which may result to paralysis of a portion of the body, this is medically referred to as hemiplegia. It is often called ‘migraine variant’, due to the one-sided paralysis, a patient with a hemiplegic migraine often experience frequent short-term paralysis on one side of the body as part of the aura symptoms. In most cases, such specific aura is usually associated with numbness of the face and finger. Other commonly manifesting symptoms include confusion, speech slurring, and visual impairment, most patients mistook the aura of a hemiplegic migraine with those of stroke and paralysis, the migraine aura can lapse for days before it subsides, although it normally goes within 24hrs. the head pain that often accompanies migraine do follows the muscle weakness, although on rear occasion, this head pain may precede the aura or it may even be absent.

There are two types of hemiplegic migraine which are the familial hemiplegic migraine (FHM) and sporadic hemiplegic migraine (SHM), these two classes are differentiated based on the family history of the patients. In the familial hemiplegic migraine, the migraines do occur among family members while in the sporadic hemiplegic migraine, no family member has been diagnosed with a hemiplegic migraine in time past. The FHM may result from a mutation in certain genes which can also be transferred from parents to their offspring.

hemiplegic migraine gene


The aura and the associated symptoms of a hemiplegic migraine often vary from individuals, the symptoms and the aura may include:

  • Impairment of vision (e.g. blind spots, flashing lights, zigzag pattern, and double vision)
  • Loss of sensory cells resulting in numbness of the face and fingers and tongue.
  • Difficulty with speech (which usually occur along with right-sided weakness)
  • There may also be a motor weakness which mostly occurs in areas with sensory symptoms and varies from mild clumsiness to complete deficit.
  • Patients also often suffer from neurological debilities such as psychosis, drowsiness, coma and confusion which may last for months.


Once the symptoms of any type of a hemiplegic migraine are noticed, it is very important to carry out various types of test to ascertain the situation, both FHM and SHM diagnosis should be through the examination of the symptoms observed by the individuals, also the medical record of the family must be critically examined. MRI test and CT scan of the head to reveal the stroke of the head is important, examination of heart and the neck’s blood vessel is also necessary to avoid misdiagnosis.

Hemiplegic Migraine Treatment

There is strong disagreement among medical practitioners on the best method of treatment for a hemiplegic migraine, however, it has been well documented that specialist advice and expertise are often required early to combat a hemiplegic migraine. Certain drugs and medication which may be used for another migraine are to be completely avoided in the treatment of hemiplegic migraine, such drug includes Triptans. Although, the combined chemotherapy for this type of migraine is yet to be established, to minimize the severity of the head pain, medical practitioners often suggest:

  • An anticonvulsant which are medications for treating seizures and bipolar disorder
  • Calcium channel blocker, a medication used for relaxing and expanding the blood vessel in the heart.