What is hemiplegic migraine?

Hemiplegic migraine symptoms include visual and sensory changes, muscle weakness, and sometimes paralysis on one side of the body.

Hemiplegic migraine is rare and presents in 0.01% of the population. Hemiplegic migraine has two subtypes:

• familial hemiplegic migraine, when the condition runs in the family
• sporadic hemiplegic migraine, when the condition appears without a family history 

Let’s look at the causes of this rare type of migraine, how it’s diagnosed, and the treatment and management options that are available.

What are the causes of hemiplegic migraine?

The symptoms of hemiplegic migraine vary for each person, but they generally include:

• aura, or visual and sensory changes
• muscle weakness on one side of the body
• numbness
• fever
• difficulty speaking 
• nausea
• vomiting
• coordination issues
• sensitivity to sound and light

The cause of hemiplegic migraine can vary from person to person. People with familial hemiplegic migraine have irregular variations in the following three genes:

• CACNA1A
• ATP1A2 
• SCN1A 

These genes make proteins that are important for the functioning of neurons and usual brain activity. These proteins play an essential role in transporting particles known as ions through a channel that connects the neurons.

These ion exchanges result in brain activity. When there are irregularities in these genes, the flow of ions is irregular. These irregularities cause problems with usual brain activity.

Researchers believe that other genes are also involved in the development of familial hemiplegic migraine. Extensive research is needed to identify and understand these genes. Hemiplegic migraine can also occur sporadically in individuals without a familial history of the condition.

What can trigger hemiplegic migraine?

Hemiplegic migraine can occur due to various factors, such as:

• drinking alcohol (if you drink)
• eating certain foods like cheese, olives, and pickles
• sensitivity to certain smells
• feeling stressful
• experiencing head trauma 
• sensitivity to bright light
• physical exertion 
• too much or too little sleep
• cerebral angiography, a diagnostic test

What medications can help treat hemiplegic migraine?

Medications are available to help prevent and manage hemiplegic migraine.

These medications include:

• anti-nausea medications
• antiseizure medications, such as valproic acid (Depakote)
• beta-blockers, such as atenolol (Tenormin)
• calcium channel blockers, such as verapamil (Verelan)
• nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin
• tricyclic antidepressants, such as nortriptyline (Parmelor)

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Can diet help with hemiplegic migraine? 

Certain foods and drinks can trigger migraine episodes. This is why your diet plays an important role in preventing migraine episodes.

Examples of foods and drinks that can trigger migraine episodes include:

• alcohol
• chocolate
• processed meats
• aged cheese
• yogurt

Consider avoiding or limiting these foods to help with hemiplegic migraine symptoms.

It may also be beneficial to keep a migraine diary to identify the foods that could result in migraine episodes.

Some foods that may help prevent episodes of migraine include foods rich in magnesium and omega-3 fatty acids, such as:

• green leafy vegetables
• avocado 
• seeds
• legumes
• mackerel
• salmon
• tuna 

Consider including these foods in your regular diet to help with the symptoms of hemiplegic migraine.

How is hemiplegic migraine diagnosed?

To diagnose hemiplegic migraine, a healthcare professional will ask about your medical and family history.

To get a diagnosis of hemiplegic migraine, you would have to have two migraine attacks with aura and muscle weakness. 

As other conditions share similar symptoms with hemiplegic migraine, a healthcare professional will also usually order tests as well to rule out other conditions. These tests include:

• CT scan: a scan that uses X-rays to see inside the body
• echocardiogram: a scan to look at the heart
• electroencephalogram (EEG): a test to record brain activity
• MRI scan: a full body scan using magnetic fields and radio waves 

Can hemiplegic migraine cause stroke?

A hemiplegic migraine shares similar symptoms with other conditions, such as stroke. While hemiplegic migraine cannot cause a stroke, they can increase your risk of having one. 

Symptoms of stroke include:

• an intense and severe headache, unlike one experienced before
• loss or blurring of vision
• difficulty in lifting both arms and keep them there
• confusion
• paralysis over one side of the body
• slurred speech
• drooping on one side of the face

If you are concerned that your hemiplegic migraine may be a sign of stroke, it is important that you seek medical attention immediately. Prompt treatment can prevent brain damage.

People with hemiplegic migraine also have an increased risk of:

• seizures
• mental health conditions, such as depression and bipolar disorder 
• cognitive decline

Consider speaking with a healthcare professional if you are concerned that your hemiplegic migraine may be a sign of another serious health condition.

Summary

Hemiplegic migraine is a rare type of migraine that affects about 0.01% of the population. It is characterized by:

• auras
• visual and sensory disturbances
• muscle weakness
• paralysis on one side of the body

There are two types of hemiplegic migraine: familial and sporadic. Certain genes cause hemiplegic migraine episodes. These genes regulate brain activity. Certain foods, stress, and bright lights may trigger these genes to cause migraine episodes.

Some medications can help treat hemiplegic migraine, such as NSAIDs and beta-blockers. Adopting lifestyle strategies such as avoiding trigger foods like cheese, meats, and alcohol can help manage migraine symptoms.  

Download the free Optum Perks Discount Card to save up to 80% on many prescription medications. Plus, you can now get them delivered to your home in as little as 3 days. Search for your medication here.