What is Hemiplegic Migraine?
Hemiplegic Migraines often have quite an alarming presentation, due to the symptoms being similar in nature to those of stroke, multiple sclerosis, epilepsy or various metabolic disorders . Hemiplegia is when one-side of the body is weakened or even fully paralysed. Hemiplegic attacks often happen with the more common symptoms of migraine, like; headache, aura, nausea and vomiting. Because of this, Hemiplegic Migraine is actually a sub-category of Migraine with Aura.
Types of Hemiplegic Migraine
1. Familial Hemiplegic Migraine
Several genes have been linked to Hemiplegic Migraine. Due to this, when a sufferer has one or more direct family members also suffering from these symptoms it is referred to as Familial Hemiplegic Migraine .
2. Sporadic Hemiplegic Migraine
When the sufferer does not have any family members who also experience Hemiplegic Migraine, it is termed Sporadic Hemiplegic Migraine. This is because of the “Sporadic Gene Mutations’ that have been found in these people [2, 3].
The prevalence of both types of Hemiplegic Migraine are low, with some research saying as low as 0.01% . As sufferers often present with ‘brainstem symptoms’, plus migraine with aura symptoms, they are often mistaken as epileptic attacks and treated unsuccessfully as such.
Symptoms for Hemiplegic Migraine may include :
- Severe unilateral headache
- One-sided weakness or paralysis
- Loss of muscle control
- Inability to comprehend or formulate language
- Numbness or tingling in the face and/or limbs
- Double Vision, or other visual disturbances
Because of the nature of these symptoms, a diagnosis must exclude a raft of other conditions. Examples include, severe migraine with aura, hemiplegic stroke, conversion disorder, multiple sclerosis epilepsy or other metabolic disorders. As there has been some link to minor head trauma and Hemiplegic Migraine, this may be used as information to aide in the differential diagnosis.
What is the cause of Hemiplegic Migraine?
In Hemiplegic Migraines, there has been an established genetic component, in both Familial and Sporadic Types. Mild head trauma has also been linked as a potential trigger. Other research suggests that dysfunction in ion channel flow in the brain and central nervous system is a component of Hemiplegic Migraine.
However, there are sufferers of Hemiplegic Migraine where there are no signs of pathology or disorder. In these patients, a sensitised brainstem may be the cause of their Hemiplegic Migraines.
This sensitised brainstem receives input from various nerves around the body, that would usually be perceived as safe, and interprets them as a threat. This over-reactive hyper-excitable brainstem then can trigger pain and the symptoms of Hemiplegic Migraine as a response to this threat.
I’ve tried it all, is there anything else that can be done?
Sufferers of Hemiplegic Migraine have often tried a huge variety of treatments and medications. They have gone through painkiller’s, triptan medication and even anti-depressants. Some patients have even been treated for epilepsy. While some of these medications have some effect, the patients are often left with the same symptoms in the end. This is where
This is where The Headache and Migraine Clinic comes in. We specialise in assessing the cervical spine and brainstem, in order to establish if they are the true cause of your symptoms. If we can establish that they are the cause, then we can begin treatment immediately. The best bit is, our treatment technique is safe, gentle, medication free and non-invasive.