How is hemiplegic migraine treated?

Updated: Oct 16, 2019
  • Author: Rima M Dafer, MD, MPH, FAHA; Chief Editor: Helmi L Lutsep, MD  more...
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Answer

Answer

In hemiplegic migraine, acute treatment options include antiemetics, nonsteroidal anti-inflammatory drugs (NSAIDs), and nonnarcotic pain relievers. Prophylactic treatment is generally warranted because of the severity of the attacks.

No data are available to support the use of any particular antimigraine agent, but beta blockers, low-dose tricyclic antidepressants, anticonvulsants, and calcium channel blockers can be administered. Acetazolamide has been frequently prescribed to patients with hemiplegic migraine, but its benefit in decreasing the frequency or severity of the attacks is questionable.

Triptans and ergotamine preparations are contraindicated because of their potential vasoconstrictive effects. [40, 41] No data support the use of antiplatelet therapy to decrease the risk of stroke.


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