A relatively uncommon kind of migraine headache known as hemiplegic migraine is defined by momentary paralysis or muscle weakness on one side of the body, frequently coupled with additional migraine symptoms. Its complexity and wide range of presentations make diagnosis and treatment extremely difficult. This thorough guide clarifies this severe neurological disorder by examining the signs, causes, diagnosis, and hemiplegic migraine headaches treatments.

It belongs to the class of migraine involving aura, in which people have additional neurological symptoms or sensory abnormalities before or throughout the headache phase. The frequency, duration, and intensity of HM attacks can vary, and they frequently result in severe disability and a reduction in everyday functioning.

Types Hemiplegic migraines

Hemiplegic migraines are classified into two categories. Which kind you have relies on the following factors:

Hemiplegic migraines with a familial connection: 

These migraines are linked genetically and run in your biological family. Hemiplegic migraines in families have three numerical subgroups. Every subtype is caused by a distinct gene mutation. If a medical professional is unable to locate a known genetic alteration, they may diagnose it as hereditary type 4.

Hemiplegic sporadic migraine: 

Individuals who have no genetic family record of migraines are at random for this type of migraine.

Hemiplegic symptoms 

Hemiparesis which indicates paralysis or weakness affecting one side of the body, are the primary hemiplegic symptoms. This may show up as stiffness in the face, limbs, or arms, which is similar to stroke symptoms. Other typical signs and symptoms of HM attacks are as follows:

Causes and Triggers of Hemiplegic migraines

Although the precise origin of hemiplegic migraine is still unknown, it is thought to be the result of intricate interactions between environmental factors and genetic predisposition. 

To function, the nervous system and brain require a mix of chemical and electrical signals. A “channel” that functions as a “gate” is opened when a strong enough electrical nerve impulse travels from a single nerve cell to another. Neurotransmitters, also known as chemical messengers, are released during this process and communicate with nearby cells to instruct them on how to react.

Serotonin and other neurotransmitters may be released abnormally when a brain channel is malfunctioning. These symptoms of hemiplegic migraine are caused by certain channels malfunctioning.

Familial variants of HM have been linked to mutations in specific genes, especially those pertaining to channels of ions and neurotransmitter control. In addition, HM attacks can be triggered by a variety of factors in vulnerable people, including stress, hormone fluctuations, specific foods, intense light, or insufficient sleep.

Diagnosis of hemiplegic migraine

Because hemiplegic migraine mimics other neurological diseases including epilepsy or stroke, diagnosing it can be difficult. It is crucial to have a complete medical history, including a family record of neurological or hemiplegic migraine disorder. Recurrent migraine headache episodes along with paralysis on one side of the body are diagnostic criteria. MRIs and other neuroimaging examinations can be carried out to rule out further underlying reasons.

Hemiplegic migraine headaches treatments 

It is advised to consult a doctor if you suspect hemiplegic migraine. This makes it possible to guarantee that you receive the best possible care. For example, it is advisable to avoid triptans throughout the aura period during SHM or FHM, and a professional should determine whether using them during the headache’s phase is safe.

Similar to other forms of migraine, there isn’t a single “optimal” course of action. A specialist will offer preventive therapies like flunarizine, topiramate, or others based on your medical history, specific symptoms, and their clinical experience.

A multidisciplinary strategy is used to treat hemiplegic migraine with the goals of symptom relief, decreased attack frequency and intensity, and enhanced quality of life. Potential treatment approaches are as follows:

Treatment for acute migraines: 

Acute episodes of hemiplegic migraine disease can be treated with over-the-counter or prescription treatments like triptans, NSAIDs, or medication for nausea.

Preventive therapy: 

To lessen the frequency and intensity of HM attacks, doctors may provide preventive treatments that involve beta-blockers, blocking calcium channels, antiepileptic medications, or antidepressants to people who experience them frequently or severely.

Lifestyle changes: 

You can help prevent HM attacks by recognizing and avoiding triggers including stress, specific foods, or environmental stimulation. Additionally helpful may be adhering to a strict bedtime routine, drinking plenty of water, and engaging in relaxation exercises.

Genetic counseling: 

To determine the likelihood that a person with familial types of HM will pass the condition forward to future generations along with offering details on family planning alternatives, genetic testing and guidance may be advised.

Risk factors

Hemiplegic migraine attacks may begin in childhood or early adulthood. If you have family history of this kind of headache, your chances are higher. You have a 50% probability of developing hemiplegic migraine if one of your parents has it.

Furthermore, certain forms of stroke can quadruple your risk if you have an aura-accompanied migraine. If you use contraceptive medications or smoke, your risk increases even further. Stroke risk is still generally rather low, though.

If hemiplegic migraine episodes are inherited in your family, there may be no way for you to avoid them. To assist you have less headaches, you can, nevertheless, take medicine. Eliminating any triggers for your migraines is another method to help stop the occurrence of hemiplegic migraine disease. As they age, some people no longer get migraine attacks. For some, the illness never goes away.



A complicated neurological condition known as hemiplegic migraine is typified by migraine headaches coupled with transient paralysis or weakness on only one side of the body. Despite being uncommon, HM can have a substantial negative influence on a person’s quality of life, necessitating a careful diagnosis and treatment by medical professionals. Health care professionals and patients can collaborate to manage hemiplegic migraine disorder efficiently and enhance patient outcomes by having a shared awareness of the condition’s symptoms, triggers, and available treatments.

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