What is hemiplegic migraine?

Updated: Oct 16, 2019
  • Author: Rima M Dafer, MD, MPH, FAHA; Chief Editor: Helmi L Lutsep, MD  more...
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Hemiplegic migraine is a very rare but well-described form of migraine variant. It was initially described in 1910 as a type of migraine consisting of recurrent headaches associated with temporary unilateral hemiparesis or hemiplegia, at times accompanied by ipsilateral numbness or tingling, with or without a speech disturbance.

Thus, a history of recurrent transient hemiplegia or hemiparesis that occurs during an attack of migraine headache suggests hemiplegic migraine. The hemiparesis may resolve before the headache or may persist for days to weeks.

The focal neurologic deficit may precede or accompany the headache, which is usually less dramatic than the motor deficit. Other migraine symptoms may be present to varying degrees. Patients may also experience disturbance of consciousness, and, rarely, coma. [6, 7, 8, 9, 10, 11] The neurologic deficit is transient and usually clears in minutes to hours, or it may resolve with the beginning of the headache phase. [12, 13, 14, 15, 16]

Two forms of hemiplegic migraine are known: familial hemiplegic migraine (FHM) and sporadic hemiplegic migraine (SHM). The 2 forms are phenotypically similar subtypes of migraine with aura, differentiated only by the unilateral motor symptoms. [17, 18]

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