Exploring Hemiplegic Migraines

Posted Tuesday, June 6, 2017

Did you know? Most people suffering from HM inherit it

On Average 50% of Children Who Have a Parent with Hemiplegic Migraine will Develop the Disorder

A Hemiplegic Migraine is Not a Stroke, However Symptoms are the Same

Hemiplegic migraines (HM) can affect your entire body and cause startling symptoms. There are a lot of factors to consider when managing and diagnosing HM and it is important to consult your provider with any concerns. 

Please use this guide as a resource for knowledge and understanding of hemiplegic migraine causes, symptoms, diagnosis, and treatment.


There are two types of hemiplegic migraine – familial hemiplegic migraine (FHM) and sporadic hemiplegic migraine (SHM). Familial hemiplegic migraine (FHM) is defined as migraine attacks occurring in two or more people in the same family who experience weakness on one side of the body as a symptom with their migraines.

At least three different genes have been implicated in FHM. In half of the families where FHM occurs, a gene with a defect on chromosome 19 has been identified. For other families chromosome 1 is implicated which alters the behavior of a channel involved in cell energy and in others a sodium channel gene on chromosome 2 is altered.

If someone experiences all the physical symptoms of FHM but doesn’t have a known familial connection, this is typically a sign of having sporadic hemiplegic migraine (SHM). The exact cause of SHM is unknown; some are due to new or so called ‘sporadic’ gene mutations.


Paralysis on one side of the body is a major symptom and a great indicator for the condition. Weakness from the attack can involve the face, arm or leg and can be accompanied by numbness and tingling pain. Impaired speech or vision, or confusion is possible. Headaches before and after can be prevalent while other symptoms usually subside after one hour.   


While a genetic test may aid in diagnosing patients with HM, it is not necessary for all affected people. Because symptoms so closely mimic other major health conditions and attacks, it is very important that all other possible conditions are tested. The diagnosis is based on the presence of having at least 2 attacks with:

  • aura accompanied by fully reversible motor weakness and fully reversible visual, sensory, and/or speech/language symptoms; and
  • at least 2 of the following 4 characteristics:
    • at least one aura symptom that spreads gradually over ≥5 minutes, and/or two or more symptoms that occur in succession
    • each individual non-motor aura symptom lasting 5 to 60 minutes, and motor symptoms lasting <72 hours
    • at least one unilateral (one-sided) aura symptom
    • the aura being accompanied by headache, or followed by headache within one hour


Medications that are effective in the prevention of common migraines may be used for hemiplegic migraines. Prophylactic management is applied to patients with frequent, long lasting, or severe attacks. Other treatments target the symptoms in an attempt to help relieve pain, panic and discomfort and allow for the least amount of discomfort. 

For more information on HM and other migraine related conditions, please visit: http://www.migrainetrust.org 

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