Understanding the Hemiplegic Migraine


Migraine. The word itself can bring anguished looks and words from a migraineur. Most migraines involve severe, sometimes debilitating headache. Most involve various aura manifestations. Yet of all the migraines, hemiplegic migraine is among the most serious.

Define Hemiplegic Migraine

The hemiplegic migraine is a very rare form of migraine. The word “hemiplegic” comes from two Greek words: hemi + plegia. “Hemi” is the same word we find in “hemisphere,” and means “half.” “Plegia” refers to a stroke or paralysis. A hemiplegic migraine causes half of the body to suffer stroke-like paralysis.

A hemiplegic migraine can cause paralysis to one arm or leg on one side of the body. It might cause paralysis before the headache begins, during, or after its beginning. Hemiplegic migraine paralysis is usually temporary, but some permanent paralysis can occur. Family history will often show other individuals suffering hemiplegic migraines.

Two Kinds of Hemiplegic Migraine

There are two variations of hemiplegic migraine:

Familial Hemiplegic Migraine (FHM) and Sporadic Hemiplegic Migraine (SHM). Familial Hemiplegic Migraine and Sporadic Hemiplegic Migraine share the same symptoms. The difference between the two is that Familial Hemiplegic Migraine can be traced in family history, linking it to mutations of specific genes on chromosomes 1 and 19. Sporadic Hemiplegic Migraine is Familial Hemiplegic Migraine without the family history. It does not show that specific genetic mutation.

Symptoms of Hemiplegic Migraine

Symptoms of a hemiplegic migraine vary from one migraineur to the next. In addition, a diagnosis of hemiplegic migraine is made difficult by the fact that its symptoms are similar to several vascular diseases. They could indicate stroke, epilepsy, or other concerns. Your physician will need to do a full neurological examination, and carefully review your medical history to rule out other underlying causes. Your family history will be helpful.

Symptoms that will alert your physician to a possible hemiplegic migraine may include any of the following. This list is not meant to be exhaustive.

  • aura episodes that last for several days or weeks
  • consciousness being impaired, from simple confusion to deep coma
  • fever
  • headache that may or may not begin before the paralysis
  • hemiplegia – paralysis on only one side of the body
  • inability to coordinate voluntary muscle movements
  • Meningismus – showing symptoms of meningitis, but not having the disease itself
  • nausea and / or vomiting
  • phonophobia
  • photophobia

The paralysis may happen suddenly, and seem to be a stroke. If you have any of the above symptoms, you should get to a physician immediately. Although many doctors have never treated a case of hemiplegic migraine owing to its rarity, yours should be able to refer you to an excellent migraine specialist who can give you proper treatment.


  1. hnjackson@umc.edu'Heidi Jackson says

    Can you provide a list of physicians who treat hemiplegic migraines? I am currently seeing a general neurologist and I need someone who specializes in this condition. It doesn’t matter the location.. will fly or drive to wherever the best doctor(s) are to treat HPM.


  2. Administrator says

    Since I personally am not a professional I would be reluctant to give any recommendations. An internet search plus follow up could turn up some recommendations. Or if any readers have personal experience with a physician, feel free to add your comments.

  3. bosticbusby@yahoo.com'Bostic B. says

    Can hemiplegic migraines be deadly? I’m a 24 yr. old male from Memphis, TN., I just found out that I have hemiplegic migraines and I’m quite afraid. My doctor referred me to a neurologist, the neurologist acted as if it was just something I should embrace and learn to live with. He really had no answers…now I’m stumped! Any info, suggestions or ideas would be greatly appreciated.

  4. KVndy@comcast.net'Kahy V says

    No, hemiplegic migraines are not deadly. I’ve had them for over 15 years and actually everyone thinks I am having a stroke – I lose my ability to speak, see (completely void of sight) and am unconscience for upwards of 30 minues. I have the paralysis (although not every migraine and no two are alike – completely unpredictable)usually for 2-4 hours but have suffered with it for a couple of weeks. Honestly, I’ve been on every med and combination of med there is and nothing works for me. I practice the biofeedback (love bio) deep relaxation and am in counseling (Cognative Behavioral Therapy) and it seems to help – why the therapy? Dealing with the disease and the lifestyle it brings is a considerable amount for a person to handle. Look, there’s no simple answer and we are all hopeful that maybe the glutamate neurotransmitter stuff is going to help us, but until then, find a good migraine specialist and someone to help with the pain. It is still difficult for me to embrace the lifestyle, it’s tough but, the fact is that all we can hope to do is treat symptoms, be proactive in helping ourselves through education and resources. Don’t be so harsh on the neurologist, he’s right in a sense, learn what works for you and take care of that. I’m sorry you are in the Hemi Club. None of us want to be a member. Good Luck. There are several good migraine clinics in your area. A good start is the http://www.americanheadachesociety.org.

  5. dianetchouros@yahoo.com'Diane T says

    Although my symptoms are not nearly as severe, this is the first time I have heard migraines described that are similar to the ones that I have. I do not lose consciousness or the ability to speak. However, my right side has symptoms that my left side does not. My right eye droops, I have to think and specifically “tell” the right arm and leg how to function. And the pain is much, much worse on the right side of my head/body. I am 45 and have been dealing with them since I was 20. Because most doctors dismissed the one-sided symptoms, I have never looked into it. I have had doctors and others look at me with “that look” when I describe the symptoms so I can’t tell you what it means to me to know that I am not the only one that deals with migrainnes that affect one half of the body that way. The things that I have done to deal with them are medication, massage and pressure points. Recently I have discovered that the P90X stretch dvd works as well or better than a massage. Thanks for the information.

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