What Are the Treatments for a Hemiplegic Migraine?

Hemiplegic migraine is a rare neurological condition that often is confused with stroke, epilepsy or vascular disease. Symptoms such as possible paralysis differentiate it from traditional migraine. Treatment of these episodes can be difficult because the diagnosis is challenging.

Types

• The two types of hemiplegic migraines are familial (FHM) and sporadic (SHM). Each initially presents during childhood and may dissipate during adulthood. FHM and SHM share the same symptoms. The only difference between the two is that FHM can be traced through the familial line and is the result of mutations in genes that play a role in nerve-cell signaling.

Symptoms

• Hemiplegic migraine has all the symptoms of traditional migraine, including intense headache, nausea, vomiting, sensitivity to light and sensitivity to sound. Additionally, the sufferer may experience episodes of prolonged aura or distinct neurological issues such as blind spots, flashing lights, double vision, drowsiness, confusion and impaired speech. Other symptoms include paralysis on one side of the body (hemiplegia), fever, meningitis-type symptoms, impaired consciousness, and loss of muscle coordination.

Expert Insight

• Seeking the advice of a migraine expert is crucial in the diagnosis and treatment of hemiplegic migraines. Because of its rarity, most doctors have never even seen a case. In addition, the similarities between hemiplegic migraine symptoms and stroke symptoms make diagnosis and treatment difficult. Most treatments for traditional migraine will exacerbate the symptoms if the patient is having a stroke.

Symptom Relief

• Medications such as triptans and ergotamines that are designed to stop, prevent or relieve the migraine process are contraindicated for hemiplegic migraine, as they may lead to stroke. These medications have vasocontrictive properties, meaning they restrict blood flow. In conjunction with the other symptoms of hemiplegic migraine, this can be extremely dangerous. For relief, patients may be given nonsteroidal anti-inflammatories such as ibuprofen; antiemetics to combat nausea and vomiting; and narcotic painkillers.

Prevention

• For FHM, the genetic profile reveals a flaw in the regulation of calcium. Therefore, one preventative measure is the use of calcium channel blockers.

Warning

• Medical experts recommend that those who are diagnosed with this rare type of migraine wear medical identification that reflects the condition. The onset of hemiplegic migraine may lead to impaired function and lack of speech. Symptoms can be managed more easily if the attack is identified quickly.