Hemiplegic Migraine

Hemiplegic migraines are a very rare form of migraines, but also the most severe and debilitating of all migraine headaches.  There are several types of migraines; most common are migraines with auras.  Hemiplegic migraines are an extreme subgroup of this category.  This type of headache is divided into two variations:  Familial Hemiplegic migraine and Sporadic Hemiplegic migraine (SHM).  Properly diagnosing this headache can be difficult, as its symptoms often appear as a vascular disease and may be confused with stroke or epilepsy.

Causes

Researchers have recently been able to identify that a gene mutation found in three different genes is the link to hemiplegic migraines.  The one difference between familial and sporadic hemiplegic migraines is the involvement of family history in familial migraines.  The mutation in these genes prevents the body from being able to properly make certain proteins in the body.  Without these essential proteins, the neurotransmitters in the body are unable to clearly communicate between nerve cells.  Most people diagnosed with this form of migraine have inherited the mutated gene from one of their parents, who also has the condition.  Different from other types of migraines, hemiplegic migraines onset in childhood and usually disappear in adulthood.

Symptoms

The stroke-like symptoms for FHM and SHM are the same and range from a mild concern to down-right debilitating.  Symptoms will vary from person to person, but also with each attack.  Symptoms of a hemiplegic migraine include:

• Severe, pulsating pain, often on only one side of your head
• Pins-and-needles sensation moving from your hand up your arm
• Numbness on one side of your body – may include arm, leg or side of the face
• Weakness or paralysis to one side of the body
• Poor balance and coordination
• Visual disturbances – double vision, blind spots, dark spots in line of vision.
• Slurred speech and other language difficulties
• Dizziness or vertigo
• Nausea and vomiting
• Extreme sensitivity to light, sound, and smell
• Loss of consciousness or even coma
• Confusion

Symptoms will onset quick and may mimic those of a stroke.  Be sure to document changes in symptoms with each episode, especially if they are progressing or appear to be getting worse with each attack, as other health issues may be involved.  Don’t ever assume that all symptoms are connected to your migraine.  Should you experience something out of the ordinary, speak to your doctor immediately.

Treatment

Finding appropriate treatment for hemiplegic migraines is difficult and opinions on treatment options vary from physician to physician.  Some doctors worry about the effectiveness of using traditional migraine medication and often suggest avoiding treatment known as triptans.  Seeking medical attention from a migraine specialist, specifically one that is comfortable with hemiplegic migraines will ease some of your treatment woes.  Also, it is important, to educate yourself about this condition and understand all that it entails and everything you may be up against.  Once a treatment plan is established with your physician, it is likely to fall into one of two categories:  abortive and pain relief or preventative.

• Abortive and Pain Relief –Triptans fall into this category of pain management.  Since the use of triptans is not recommended for hemiplegic migraines, due to stroke concerns, other options are available.  Non-steroidal anti-inflammatory (NSAIDs), antiemetic, and narcotic analgesics are common and safe for the use of pain relief accompanying hemiplegic migraines.  NSAIDs are used for pain relief and inflammation.  Common examples are Ibuprofen and Aleve.  Antiemetic drugs are used for treating nausea and vomiting, such as Zofran.  Lastly, narcotic analgesics are the strongest form of medication that may be used.  This medication is intended to relieve pain and create numbness, even act as a sedative.
• Preventative – The most common form of treatment for hemiplegic migraines, given the risk of using the abortive triptan medication.  Doctors may prescribe an anti-convulsant drug or calcium channel blocker to help reduce the frequency and severity of future migraine attacks.

Due to the severe complications associated with hemiplegic migraines, those diagnosed are encouraged to wear a medical identification bracelet.  Should you lose consciousness or your ability to speak during an attack; this will provide medication practitioners with valuable information in assisting you in an emergency.

Tags: Acetaminophen (a.k.a. Tylenol), migraine pain, migraine relief, Non-steroid anti-inflammatory drugs (NSAID), over the counter medication, treating migraines