Hemiplegic Migraines

Hemiplegic migraines are sometims called familial hemiplegic migraine. This type of migraine was initally described in literature in 1910. It is usually a recurring headache type.


This headache can be very frightening as it is one of those migraines that mimics a stroke. It can be associated with the following symptoms.

  • temporary one sided weakness (arm, leg or both)
  • possible tingling in the opposite limbs
  • difficulty talking or slurred speech
  • headache that is migrainous
  • loss of balance
  • decreased conciousness or unconciousness

The symptoms may be less prominent than the headache and usually resolve within the headache phase.

The "familial" part refers to the fact that there is a genetic relationship and the genes have been located. There are three of them and they are FHM1, FHM2 and FHM3.

A second type of headache that is similar for FHM is sporatic hemiplegic migraine. The difference between the two is that SHM occurs only sporatically in a person's life whereas the FHM is definitely much more often.

Treatment of Hemiplegic Migraine

Generally speaking abortive medications such as triptans and ergotamines are contraindicated in this situation. This is because the risk of stroke, and these medications are very vasoconstrictive.

Prophylactic or preventative therapy is usally the treatment given. Medications such as verapamil or beta-blockers such as inderal are the best to try first.

Patients with hemiplegic migraines should consider wearing or carrying medical identification about their condition. This is because if you are semi-concious or unconcious, medical providers need to know about your medical problems.

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