Is your migraine hemiplegic? This is a question many people who suffer from migraines find themselves asking. In this article, we’ll answer this question, providing a comprehensive overview of the symptoms of hemiplegic migraine, diagnosis, and treatment options.
What is a Migraine?
A migraine headache is a type of headache that is typically characterised by a severe throbbing pain on one side of the head. It is a common neurological condition that affects millions of people worldwide. Migraines can last anywhere from a few hours to several days, and they often come with other symptoms such as nausea, vomiting, and sensitivity to light and sound. Migraine attacks can be debilitating, causing significant disruptions to daily life. Understanding the different types of migraines, their triggers, and available treatment options can help individuals better manage their condition and improve their quality of life.
Types of Migraine
There are several forms of migraine, each with its own set of symptoms and characteristics. Understanding the different types can help in effectively managing the condition.
- Migraine with aura: These common migraines are characterised by neurological symptoms that occur before or during a migraine attack. These symptoms can include visual disturbances such as blind spots or flashing lights, as well as sensory changes like tingling or numbness in the face or hands.
- Migraine without aura: These are migraines that do not have any associated neurological symptoms. These migraines typically present as moderate to severe headaches that can last for hours or even days.
- Silent migraines: Also known as acephalgic or migraine equivalents. These migraines are characterised by aura symptoms without the headache pain. This means that individuals will experience the visual symptoms or sensory changes associated with a migraine aura, but without the accompanying headache.
- Hemiplegic migraine: This type of migraine is characterised by temporary paralysis or weakness on one side of the body. This can affect the face, arm, or leg and usually lasts from a few minutes to several hours.
It is important to note that these are only a few examples of the different types of migraines. Each individual may experience migraines differently, and it is recommended to consult with a healthcare professional for an accurate diagnosis and appropriate treatment.
Is My Migraine Hemiplegic?
Hemiplegic migraine is a rare and complex form of migraine that is associated with temporary paralysis or weakness on one side of the body. This can affect the face, arm, or leg and can last anything from just a few minutes to many hours. Hemiplegic migraine can be a frightening and debilitating condition, as it can cause significant disruption to daily life activities. Along with the physical symptoms, individuals may also experience other migraine symptoms such as severe headaches, sensory disturbances, and visual disturbances.
Symptoms of Hemiplegic Migraine
If your migraine is hemiplegic migraine, you might experience the following symptoms:
- Weakness on one side of the body. This can affect the arm, leg, or both.
- Numbness or tingling sensations in the weak side of the face or limb.
- Visual disturbances. These may include blind spots, blurred vision, or even temporary blindness in one eye.
- Trouble speaking or slurred speech.
- Drowsiness.
- Dizziness, and loss of coordination.
Some individuals may also experience more serious symptoms such as confusion, loss of control over movement, decreased consciousness, and memory loss. If you experience any of these symptoms and this is unusual for you, seek urgent medical attention.
It is important to note that not everyone will experience all of these symptoms during an episode of hemiplegic migraine. Some individuals may experience a combination of these symptoms, while others may only experience a few.
Visual Disturbances Associated with Migraines
Migraines are a neurological condition that can cause a range of symptoms, including visual disturbances. These visual disturbances, known as aura, can occur before or during a migraine attack and are experienced by about 20% of migraine sufferers. These visual disturbances can be unsettling and may interfere with daily activities.
Blind Spots or Visual Loss During an Attack
During a hemiplegic migraine attack, patients may experience blind spots or visual loss, including a specific subtype known as ocular migraine. These visual disturbances can cause temporary loss of vision in one eye and typically occur in the same eye during each attack.
Blind spots are areas in the field of vision where there is a complete absence of visual perception. They can range in size, from small spots to larger areas, and they can obscure or partially block the patient’s visual field. Visual loss refers to a temporary or transient decrease in the ability to see clearly or complete loss of vision in one eye.
It is important to note that sudden loss of vision during a migraine attack may not always be related to the migraine itself. In some cases, it could indicate another underlying cause that requires urgent medical attention. Therefore, it is crucial for individuals experiencing sudden vision loss during a migraine attack to seek immediate medical evaluation.
Flashing Lights, Zig Zags, or Halos Around Objects
Visual disturbances are a common symptom experienced during migraine attacks. These disturbances can manifest as flashing lights, zig zags, or halos around objects.
During a hemiplegic migraine attack, these visual disturbances can be particularly intense. Patients may see bright, flickering lights or jagged lines that appear to move across their visual field, often referred to as zig zags. These zig zags can be colourful and may distort or block the patient’s vision.
In some cases, patients may also experience halos around objects, making them appear blurry or distorted. These halos can make it difficult to focus on specific objects or read clearly.
It is important to note that these visual disturbances are temporary and usually resolve once the migraine attack subsides. However, they can be a source of discomfort and anxiety during an attack.
If you experience these visual disturbances during a hemiplegic migraine attack, it is recommended to find a quiet and dark environment to rest and minimise stimuli. Applying a cold compress or closing your eyes may also provide some relief.
Post-Migraine Symptoms After an Attack
After an attack of hemiplegic migraine, patients may experience a range of post-migraine symptoms. These symptoms can vary in severity and duration between individuals but can greatly impact daily life.
One common post-migraine symptom is memory loss. Patients may have difficulty recalling events or experiences that occurred during or shortly before the migraine attack. This memory impairment can be temporary, lasting a few hours or days, but in some cases, it may persist for a longer period.
Cognitive impairment is another common symptom. Patients may struggle with concentration, focus, and problem-solving abilities. This mental fog can make it challenging to perform tasks that require mental clarity and can be frustrating for individuals.
In some cases, chronic symptoms can develop after a hemiplegic migraine attack. These symptoms can include ongoing headaches, fatigue, dizziness, and mood disturbances. The duration and intensity of these chronic symptoms can vary, but they can significantly impact the quality of life.
Although rare, the development of seizures is also possible after a hemiplegic migraine attack. Seizures can manifest as brief episodes of abnormal movements, loss of consciousness, or changes in awareness. It is essential for individuals experiencing these symptoms to seek medical attention for appropriate evaluation and treatment.
It is important to note that every individual’s experience with post-migraine symptoms can differ. Some may have mild or nonexistent symptoms, while others may experience more severe and long-lasting effects.
Hemiplegic Migraine vs. Stroke
Hemiplegic migraine is a unique type of migraine that can often mimic stroke-like symptoms. While there are similarities between the two conditions, it’s important to understand the differences in order to receive appropriate medical attention.
Like a stroke, hemiplegic migraine can cause temporary paralysis or weakness on one side of the body. However, there are key distinctions. Hemiplegic migraine symptoms tend to come on slowly and may completely go away, whereas a stroke usually has a sudden onset and requires immediate medical intervention.
If you experience sudden weakness or paralysis, it’s crucial to seek urgent medical attention to rule out a stroke or other serious conditions. A healthcare professional can assess your symptoms and determine the appropriate course of action. It’s important to note that hemiplegic migraine is a diagnosis of exclusion, which means that other potential causes of weakness need to be ruled out.
Causes and Risk Factors of Hemiplegic Migraine
While the exact cause of hemiplegic migraine remains unknown, there are certain factors that can increase the risk of developing this condition.
One significant factor is a genetic component. Studies have shown that hemiplegic migraine often runs in families, with a 50% chance of inheritance if one parent has the condition. Several genes have been identified to be associated with hemiplegic migraine, including CACNA1A, ATP1A2, SCN1A, and PRRT2.
Defects in these genes can impact the production of certain proteins and neurotransmitters in the brain, leading to abnormal neurological symptoms like those experienced during a hemiplegic migraine attack. For example, mutations in the CACNA1A gene can affect calcium channels in the brain, which play a crucial role in regulating electrical signals. Similarly, defects in ATP1A2, SCN1A, and PRRT2 genes can disrupt the normal functioning of ion channels and neurotransmitters.
It is also worth noting that attacks of hemiplegic migraine often start in childhood or young adulthood. Hormonal changes, such as those that occur during puberty or the menstrual cycle, can trigger or worsen migraines in some individuals.
While understanding the causes of hemiplegic migraine is important, it is equally crucial to recognise and manage the associated risk factors. If you have a family history of hemiplegic migraine or have been experiencing symptoms indicative of the condition, it is recommended to seek medical attention. A healthcare professional can provide a thorough evaluation, accurate diagnosis, and appropriate treatment options tailored to your specific needs.
Other Genetic Mutations Linked to Different Types of Migraines
Migraines are a complex neurological condition that can have various types and presentations. In some cases, genetic mutations have been found to be associated with specific types of migraines, including familial hemiplegic migraine (FHM).
FHM is a rare subtype of migraine that is characterised by episodes of hemiparesis or hemiplegia, which are temporary paralysis or weakness on one side of the body. There are currently three known genes related to FHM, namely FHM1, FHM2, and FHM3.
It is important to note that not all individuals exhibiting hemiplegic migraine symptoms have these specific gene mutations. In fact, a significant percentage of patients do not have any identified genetic abnormalities. This suggests that there may be additional genes involved in the pathogenesis of migraines, and further research is needed to uncover them.
Diagnosis and Treatment Options for Hemiplegic Migraine
Diagnosing hemiplegic migraines can be challenging due to their similarity to other conditions. However, medical professionals follow a systematic approach to accurately diagnose this subtype of migraine.
To diagnose hemiplegic migraines, doctors typically rely on the patient’s medical history and a thorough physical examination. It is essential to provide a detailed account of symptoms experienced during a migraine attack. Neurological symptoms such as paralysis or weakness on one side of the body, speech difficulties, and visual disturbances are common with hemiplegic migraines.
In some cases, additional tests may be conducted to rule out other conditions and confirm the diagnosis. These may include brain imaging scans, such as magnetic resonance imaging (MRI) or computed tomography (CT) scans. These tests help identify any abnormalities in the brain that may contribute to the migraine attacks.
Treatment for hemiplegic migraines focuses on relieving symptoms during an attack and preventing future episodes. During an episode, pain relief medications, such as nonsteroidal anti-inflammatory drugs (NSAIDs) or triptans, may be prescribed to alleviate the severe headache and other symptoms. Anti-nausea medications can also be helpful in managing associated gastrointestinal symptoms.
In terms of prevention, various options are available. Preventive medications, such as calcium channel blockers or antiepileptic drugs, may be prescribed for individuals experiencing frequent or severe attacks. Lifestyle changes, including stress management, regular sleep patterns, and avoiding trigger factors like bright lights or certain foods, may also be incorporated into the treatment plan.
FAQs
Can you have hemiplegic migraine with no headache?
Yes, it is possible to experience a hemiplegic migraine attack without a headache. While headaches are a common symptom of migraines, individuals with hemiplegic migraine may experience other neurological symptoms without the presence of a headache.
Some individuals may develop a headache after the other symptoms of a hemiplegic migraine attack have subsided, while others may not experience a headache at all.
Should I go to A&E if I have a hemiplegic migraine?
If you are experiencing a hemiplegic migraine, it is important to know when to consider seeking medical attention, such as going to the Accident and Emergency (A&E) department. While many hemiplegic migraines can be managed at home with appropriate treatment and support, there are certain circumstances in which it is crucial to seek immediate medical attention.
One such instance is if you experience sudden and unexpected new symptoms during a hemiplegic migraine attack. These symptoms may include severe or prolonged weakness or paralysis on one side of the body, difficulty speaking or understanding speech, confusion or disorientation, or any other unusual or alarming neurological symptoms. These can be signs of a more serious underlying condition that requires urgent medical evaluation and treatment.
Additionally, if you are uncertain about the nature of your attack or if it differs significantly from your usual hemiplegic migraines, it is advisable to go to A&E. It is always better to be safe and have your symptoms evaluated by a healthcare professional to rule out any potentially serious causes.
Remember, seeking medical attention for your hemiplegic migraine does not necessarily mean you will always need to go to A&E. You can also contact your GP for management of the more chronic effects of migraine.
Can I continue to drive with hemiplegic migraine?
If you suffer from hemiplegic migraine, it is important to consider the guidelines for driving during a migraine attack. Hemiplegic migraine is a debilitating form of migraine that is characterised by temporary paralysis or weakness on one side of the body. As a result, it can significantly impair your ability to safely operate a vehicle.
During a hemiplegic migraine attack, it is highly recommended to avoid driving. The sudden onset of severe weakness or paralysis, along with other neurological symptoms such as difficulties in speaking or understanding speech, confusion, or disorientation, can pose serious risks on the road. These symptoms can compromise your reaction time, coordination, and overall cognitive function, which are essential for safe driving.
If you have been diagnosed with hemiplegic migraine, it is important to comply with the driving regulations set forth by your local driving authorities. In the UK, for example, you are required to inform the Driver and Vehicle Licensing Agency (DVLA) if you have a medical condition, such as hemiplegic migraine, that may affect your ability to drive safely. Similarly, in other countries, you may have to inform your local driving authority, such as the Department of Motor Vehicles (DMV), about your condition.
For further advice on when to inform the DVLA, visit the Migraine Trust’s website. You can also discuss your individual circumstances with the DVLA directly.
How long does a hemiplegic migraine normally last?
On average, a hemiplegic migraine attack can last anywhere from four hours to three days. During this time, individuals may experience various neurological symptoms, such as temporary weakness or paralysis on one side of the body. This weakness can last anywhere from one to 24 hours.
It is important to note that the duration of a hemiplegic migraine attack can vary from person to person. While some individuals may experience shorter episodes that last only a few hours, others may have longer-lasting attacks that linger for a few days.
Is there a cure for hemiplegic migraine?
At present, there is no known cure for hemiplegic migraine. However, several treatment options are available to help manage and alleviate the symptoms associated with this condition.
The primary goal of treatment is to reduce the frequency and severity of hemiplegic migraine attacks. Preventive medications, such as topiramate, are often prescribed to help achieve this. These medications work by modulating neurotransmitters and reducing the sensitivity of blood vessels in the brain, ultimately helping to prevent the onset of an attack.
In addition to preventive medications, acute treatments are used to relieve symptoms during an attack. These may include medications like pain relievers, anti-nausea drugs, and triptans, which work by constricting blood vessels and inhibiting the release of certain chemicals associated with migraine pain.
It is important to note that treatment plans for hemiplegic migraine may vary from person to person. Identification of individual migraine triggers and avoidance may be a key aspect of ongoing management.
While a cure for hemiplegic migraine is yet to be discovered, the available treatment options can significantly improve the quality of life for individuals living with this condition. Seeking medical attention and discussing symptoms with a healthcare professional are essential steps toward effectively managing hemiplegic migraine.
Is hemiplegic migraine classed as a disability in the UK?
When it comes to classifying hemiplegic migraine as a disability in the UK, the criteria set forth by the Equality Act 2010 come into play.
Under the Equality Act 2010, a person is considered to have a disability if they have a physical or mental impairment that has a substantial and long-term adverse effect on their ability to carry out normal day-to-day activities. The key factors determining whether hemiplegic migraine is classified as a disability include the severity of the condition and its impact on the individual’s daily activities.
Given the disabling symptoms associated with hemiplegic migraine, such as temporary paralysis, speech difficulties, and sensory disturbances, it is more likely to be classified as a disability under the Equality Act. This recognition ensures that individuals with hemiplegic migraine are entitled to certain rights and protections, such as reasonable adjustments in the workplace and protection against discrimination.
If you believe that your hemiplegic migraines meet the criteria outlined by the Equality Act 2010, it is recommended to seek professional advice and guidance to understand your rights and explore available support options.
