This is a very exceptional and severe form of a migraine which is a subtype of a Migraine with Aura. There are two types of Hemiplegic Migraine.
- Familial Hemiplegic Migraine (FHM) where the attack occurs in two or more people in the same family.
- Sporadic Hemiplegic Migraine (SHM) where the symptoms will be same as familial hemiplegic migraine and doesn’t have any connection within their family but caused due to gene mutations. The genetic mutations make the brain sensitive, most probably by increasing the brain levels.
Both FHM and SHM often begin in childhood and end during adult years. A hemiplegic migraine causes temporary paralysis or weakness on one side of the body lasting for several hours, days, or weeks prior or during a headache pain. The other symptoms include
- Vertigo
- Ataxia (Lack of coordination of muscle movements)
- Coma
- Visual disturbance
- Problem in speech
- Trouble swallowing
- Loss of balance
- Epilepsy (Group of neurological diseases)
The FHM and SHM share the same symptoms. The difference between the two is that FHM can be tracked by family medical history. SHM is without the family connection and that by particular genetic mutation.
Though rare, at least, three genetic subtypes are identified in Familial Hemiplegic Migraine they are
- Familial hemiplegic migraine1 (FHM1) which records 50% of patients, caused by coding gene mutations for the calcium channel (CACNA1A) a subunit which also associated with cerebellar degeneration.
- Familial hemiplegic migraine2 (FHM2) which records less than 25% of patients, caused by mutations in sodium-potassium pump gene (ATP1A2) which is high concentrations of potassium ions but low concentrations of sodium ions and the mechanism responsible for this is the sodium-potassium pump.
- Familial hemiplegic migraine3 (FHM3) is a rare subtype of FHM, caused by mutations in sodium channel a subunit coding gene (SCN1A)
Migraine specialist speaking about Hemiplegic Migraine
Treatment
There is a dissimilarity over how to treat Hemiplegic Migraines. Many doctors have never treated a patient with this type of a migraine so it is recommended to consult a renowned migraine specialist with a customary track record for treatment of Hemiplegic Migraine. Most doctors feel easy in using Triptans as a medication for treating the patients of this type of a migraine. However, your doctor may prescribe other medications which include
- Anticonvulsant medication or calcium channel blocker which will moderate the severity of attacks in future. These are preventive medications.
- For acute attacks many doctors suggest Triptans as stated above, different Triptans are available like Sumatriptan, Zolmitriptan, Naratriptan, etc,
- According to clinical research the best option for treating hemiplegic migraine is with either Flunarizine or Topiramate.