Hemiplegic migraine is a rare type of migraine, and the symptoms can sometimes be mistaken for a stroke. The condition, sometimes referred to as a migraine variant, can run in families, and some patients with the illness may have genetic abnormalities that exacerbate their symptoms.
Let’s investigate some of the common signs of hemiplegic migraines, as well as the two different types that a patient can experience now.
Types of Hemiplegic Migraines
Two types of hemiplegic migraines are currently identified. The first of these, familial hemiplegic migraine, occurs when two or more members of the same family experience migraines together with weakness on one side of the body.
Among children who have a parent with familial hemiplegic migraine, it is estimated that half of them will later develop the condition themselves. Research has discovered that a particular genetic defect on chromosome nineteen is involved in at least fifty percent of familial cases.
The other type of hemiplegic migraine, known as sporadic hemiplegic migraine, is diagnosed in patients who have symptoms without any family history of the disorder.
Hemiplegic migraines of both types typically start in childhood or as a teenager, and the condition affects approximately one in every ten thousand individuals.
Generally, episodes of hemiplegic migraines become less frequent as the patient ages. Occasionally, some children with the illness will outgrow this condition by the time they reach adulthood. Fortunately, specialist migraine clinics can help with treatment options.
Signs and Symptoms of Hemiplegic Migraine
1. Numbness or Tingling on One Side
Numbness or tingling on one side of the body is a major symptom of hemiplegic migraines that a patient may not experience with other types of migraines.
Most commonly, the numbness or tingling with this condition will be located on one side of the face or in an arm or leg. A tingling feeling may start in one hand and move up the body into the arm.
The numbness and tingling can cause a loss of balance and coordination as well. As these symptoms can also be part of epilepsy and other neurological conditions, it is critical that anyone who experiences them for the first time seeks emergency medical attention at a hospital.
2. Weakness on One Side of The Body
This classic symptom of hemiplegic migraines is used by doctors to distinguish them from other types of migraines. The weakness felt on one side of the body can affect either side of the body, and often happens before the person starts to experience pain in their head from the migraine itself.
Eighty to ninety-nine percent of patients with this illness experienced one-sided weakness. In one study, patients with sporadic hemiplegic migraines reported that they most commonly experienced weakness in their upper limbs, such as their arms, with their lower limbs being affected much less often.
The one-sided weakness usually lasts less than one day, although it can last up to three days. Sometimes, the weakness progresses to temporary paralysis, known as plegia, which is an inability to use the affected side of the body during an attack.
While motor functions almost always return to normal following a hemiplegic migraine, rarely, some patients have been left with lasting movement and coordination difficulties.
Hemiplegic migraines are unpredictable, and one episode may only bring slight pain or weakness, while the next could be more severe, or vice versa.
3. Speech Difficulties
Speech difficulties are another common symptom that this condition shares with other neurological disorders, including strokes. Often, speech difficulties are part of a cluster of warning symptoms, called an aura, that occur before the arrival of the migraine and head pain itself.
In the case of a hemiplegic migraine, difficulty with speaking usually occurs in the form of slurred speech, and it may be accompanied by confusion, drowsiness, and sensitivity to smell or sound.
Patients experiencing speech problems during an attack may also have language difficulties, including trouble remembering a word for an object.
Similarly, they might mix up their words, using an incorrect word for a particular item. Generally, trouble with speech only lasts for about one hour, although it can extend to a few hours. It very rarely lasts more than one day, although some patients have reported longer-term effects.
4. Double Vision
Double vision is one of the many types of visual disturbances that occur with hemiplegic and other types of migraines.
Visual problems are generally part of the aura that comes before the headache. In addition to double vision, patients have reported seeing zigzag lines, sparkle or shimmers, dots, flashing lights, and even blind spots in their vision.
Between thirty to seventy-nine percent of patients may also experience nystagmus, which is very rapid, rhythmic eye movements that are completely involuntary. These visual changes are frequently accompanied by a sensitivity to light that can be extreme.
Like other aura symptoms, vision changes can start slowly and build over the course of thirty minutes or longer, lasting for up to a few hours before disappearing. While a patient’s vision typically returns to normal, in some rare instances, long-term problems can occur such as involuntary eye movements, have been documented.
This is often one of the first symptoms of a hemiplegic migraine attack and can be part of a patient’s aura.
While it is common in other types of migraines, in many cases of a hemiplegic migraine, the dizziness can be severe. It may also be accompanied by feeling lightheaded or just feeling generally unwell, known as general malaise.
Some patients may experience vertigo, which is a related symptom. With vertigo, patients who are standing still feel a sense of rotation or rocking. They may feel as though the world around them is spinning. Both dizziness and vertigo may lead to loss of balance and falls.
Sometimes, the sensation of feeling dizzy can also contribute to a feeling of nausea or to vomiting, both of which have occurred in patients with a hemiplegic migraine.
Fortunately, most hemiplegic migraine patients will find that their feeling of dizziness subsides within a few hours after an attack.
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