Everything You Always Wanted to Know About Numbness and Hemiplegic Migraines

Quincy AdamMigraine Learn

Migraine concept
After the birth of her twins, Tracey Wilson was paralyzed on her left side and had difficulty speaking. Doctors told her she had had a stroke, and she would recover. The problem, however, endured for over two years. Finally, she was diagnosed correctly with a hemiplegic migraine — an extreme form called “status migrainous,” which lasts around the clock.1

If you’ve experienced numbness that you believe is associated with your migraines, the likelihood is that it’s not as persistent as Tracey’s health condition. Nonetheless, you want to understand it better. Below is the information you’ll need to know about hemiplegic migraines, the form that causes numbness.

What Is a Hemiplegic Migraine?

A hemiplegic migraine is a rare form of migraine, often beginning during childhood and ending during adulthood. In addition to numbness and pins and needles on one side of your body, you may be weak for one to several days.

What’s going on?

Nerve cells communicate with each other via electrical impulses. These impulses tell other cells, such as muscle cells, to act. As they travel through the body to reach other cells, nerve impulses have to be strong enough to open a channel that acts as a gate. In a hemiplegic migraine, the channels do not work correctly.2 The result is that the neurotransmitters and nerve cells in your body don’t work properly, causing those sensations.

There are two types of hemiplegic migraines: familial (FHM), which is hereditary, and sporadic (SHM), which has no known familial connection. Medical researchers have traced FHM to a mutation of genes on chromosomes 1 and 19, the calcium channel. “The mutant calcium channel does not open and close properly and cannot regulate the amount of calcium coming into the cell, so calcium influx and efflux regulation goes awry. This in turn leads to neurons firing too easily.”3

Diagnosis

As shown in Tracey’s story, it’s not always easy to diagnose a hemiplegic migraine. That’s because it masquerades as other diseases, such as stroke or epilepsy. If you’re concerned that you suffer from this condition, your doctor will likely want you to have a complete neurological exam. The examination might include a CT scan or MRI of your head. Also, the doctor might order tests to evaluate your heart or blood vessels in your neck to see if there may be blood clots that cause your symptoms.

He or she will review your medical history and symptoms as well.

Symptoms they look for include:

  • pounding headaches on one side of your head
  • visual aura
  • numbness and pins and needles
  • dizziness
  • nausea
  • memory loss and confusion
  • sensitivity to light, noise and odors
  • weakness or paralysis on one side

These symptoms would be more severe than those experienced with regular migraines with aura.

Treatment

Unfortunately, medical professionals have not reached a conclusion on the best way to treat hemiplegic migraines. Usually, however, migraine treatments fall into two categories — preventive and abortive.

The abortive treatments that doctors often recommend for migraines, triptans and ergotamines, are not advised for this type of migraine. Because these medications constrict the blood vessels, health professionals are concerned they might lead to strokes. Instead, doctors recommend nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin, ibuprofen or naproxen. Other options are antiemetics, which are often used to treat motion sickness, and narcotic analgesics, which reduce neuron volatility in the pain carrying pathway.

Because there is no ideal medication yet to abort a hemiplegic migraine, prevention is critical. Since the gene mutations of FHM can lead to calcium being poorly regulated in the body, calcium channel blockers are sometimes used for prevention.

Seek Help

If you are experiencing numbness, paralysis, and/or debilitating headaches and think you might suffer from hemiplegic migraines, seek help from a medical professional. For the best quality of life, you need an accurate diagnosis and to find out how you should best manage your condition.


1 Carroll, Helen. “My ‘stroke’ was a migraine that lasted for TWO YEARS.” www.dailymail.co.uk/health/article-2061529/My-stroke-migraine-lasted-TWO-YEARS.html. Accessed March 28, 2016.
2 “Hemiplegic Migraine.” http://www.migrainetrust.org/factsheet-hemiplegic-migraine-10913. Accessed November 18, 2015.
3 Tepper, Stewart J., M.D. “Understanding Migraine and Other Headaches.” University Press of Mississippi. 2004. p. 23.