Migraines are severe headaches which occur sporadically in some people. It is not entirely understood what causes migraines. One kind of atypical migraine, known as a hemiplegic migraine, involves partial paralysis of the body. This disease can run in families and can be particularly difficult to treat.
Symptoms
Hemiplegic migraines are notable because they can cause paralysis of one side of the body and impaired speech and senses, according to migraine expert Teri Robert. Hemiplegic migraines can also be preceded by a severe headache, though not all hemiplegic migraines involve a headache. Other symptoms resemble those caused by meningitis, though there is no inflammation occurring around the brain. These symptoms include a fever, a severely stiff neck and confusion. Patients suffering from a hemiplegic migraines may also be extremely sensitive to light and sounds. They may also experience nausea, vomiting and problems with muscle coordination.
Types
There are two main forms of hemiplegic migraine. One form, known as familial hemiplegic migraine, runs in families. The other form, which is known as sporadic hemiplegic migraines, involves the same symptoms as the familial form but does not appear to have a genetic component. Both of these forms typically manifest during childhood and go away once the patient is an adult, Teri Robert notes.
Genetics
Mutations in three different genes can result in familial hemiplegic migraine, the Genetics Home Reference explains. These genes are known as ATP1A2, SCN1A and CACNA1A. These genes are involved in controlling neural activity and mutations in any of these genes can result in abnormal activity in the brain which can cause hemiplegic migraines. Patients only need one mutation in any of these genes to develop hemiplegic migraines. Females are more likely to suffer from familial hemiplegic migraines than males, though researchers have not identified why this is the case.
Complications
Patients with hemiplegic migraines can have unusually severe migraines, the Genetics Home Reference explains. In some cases these migraines can result in a coma or death. In addition, although most patients who suffer from hemiplegic migraines are able to fully recover in between attacks, they may suffer from problems with paying attention and memory loss for several weeks after the migraine. In addition, some patients develop permanent neurological problems, such as problems with muscle coordination and involuntary eye movements, also known as nystagmus.
Diagnosis
Hemiplegic migraines can be difficult to diagnose because the paralysis can resemble that caused by other diseases, such as a stroke. Typically doctors will need to confirm that the patient has had at least two migraine episodes involving paralysis and other symptoms which completely resolve over time. In addition doctors will ask about the presence of an aura, which is a characteristic set of visual disturbances, such as zigzag lines, flashing lights or blind spots which precede migraines. Additional tests, such as a MRI, may need to be done to rule out other migraine causes.
Treatment
Many of the standard treatments for migraines, such as drugs in the triptan family, are not recommended because of concerns that they could lead to a stroke. As a result, medications such as non-steroidal anti-inflammatory drugs, anti-nausea medications and narcotic pain relievers are commonly used medications for the treatment of these kinds of migraines.
