Migraines & Headaches Health Center

Hemiplegic Migraine Headaches

Hemiplegic migraine is a rare type of headache. It's also one of the most serious and potentially debilitating migraine headaches.

What Is a Hemiplegic Migraine Headache?

There are several types of migraine. One major group is called migraine with aura. Hemiplegic migraine is a severe subtype of this group.

Migraine is a complex neurological disorder. It generally includes headaches, but not always. Before the actual headache pain of a migraine, you can have a host of other symptoms that serve as warning signs that a migraine is coming. These early symptoms, called auras, include temporary disturbances in one or more functions:

• Vision
• Muscle control and body sensations
• Speech and language
• Hearing

For most migraine sufferers who have aura, the visual disturbances are the most common symptom. But for people with hemiplegic migraine, muscle weakness and paralysis can be so pronounced and extreme that they cause a temporary, stroke-like paralysis on one side of the body. This paralysis on one side of the body is called hemiplegia.

What Are the Symptoms of Hemiplegic Migraine Headaches?

Hemiplegic migraine symptoms often start in childhood. Then for some people, they disappear in adulthood. The stroke-like symptoms can range from worrisome to debilitating. Migraines are unpredictable and unique to each person. You may have a hemiplegic migraine headache with extreme pain and minor paralysis one month. Then, the next attack might bring extreme paralysis without much headache pain at all.

Symptoms of hemiplegic migraine include:

• Severe, throbbing pain, often on one side of your head
• A pins-and-needles feeling, often moving from your hand up your arm
• Numbness on one side of your body, which can include your arm, leg, and/or one side of your face
• Weakness or paralysis on one side of your body
• Loss of balance and coordination
• Visual aura, such as seeing zigzag lines, double vision, or blind spots
• Language difficulties, such as mixing words or trouble remembering a word
• Slurred speech
• Dizziness or vertigo
• Nausea and vomiting
• Extreme sensitivity to light, sound, and smell
• Confusion
• Decreased consciousness or coma

With hemiplegic migraine, the aura can be more severe and last longer than with other types of migraine with aura. Symptoms usually last from five minutes to one hour. It's rare, but some people gradually develop long-lasting difficulty with movement and coordination.

What Causes Hemiplegic Migraine Headaches?

Researchers have now identified three genes linked with hemiplegic migraine.

The three genes linked with hemiplegic migraine are the CACNA1A, ATP1A2, and SCN1A genes. Defects, or mutations, in any of these three genes lead to a breakdown in the body's ability to make a certain protein. That protein is needed for clear communication among nerve cells. Without that protein, nerve cells have trouble releasing or taking up neurotransmitters -- the chemical messengers between nerve cells. 

Most people with hemiplegic migraine have inherited the gene mutation from one parent who also had the condition.