Hemiplegic Migraine Treatment: Familial Hemiplegic Migraine

Migraine describes a disease in which the vessels in the brain have spasms that cause a change in blood flow.  Sometimes this causes extreme pain and at other times it causes visual problems. There is also a different set of symptoms caused by migraine that is much more severe. These are called hemiplegic migraines.

The episodes of migraine are a neurological disease. Familial hemiplegic migraines (FHM) are a rare type of migraine that stem from a family history of this particular disease.  The onset of hemiplegic migraines usually begins in childhood and tends to be absent in adulthood. Because FHM often mimics vascular disease, it is often difficult to get a definitive diagnosis. Often, familial hemiplegic migraine presents symptoms typical of a stroke or epilepsy. In order to get a real diagnosis, one would have to have a full neurological exam along with family history in order to rule out vascular disease.

There are two types of hemiplegic migraine; FHM and SHM (Sporadic hemiplegic migraine). The two are the same except FHM arises in the context of a family history of the disease, whereas SHM has no family history. FHM is caused by a genetic mutation that has been traced back to one certain gene on the 1st and 19th chromosome. 

Symptoms of Hemiplegic Migraine

The symptoms are the same for both FHM and SHM.  Those symptoms are as follows:

• Visual disturbances or aura that can last for days or even weeks. The patient's vision may seem like they are looking through a broken window or may have a zig-zag appearance.
• Hemiplegia or having paralysis on just one side of the body. This symptom generally comes on suddenly and is often confused with stroke. For this reason it is advised to wear a medical ID bracelet if you have been diagnosed with familial hemiplegic migraines.
• Fever
• Symptoms of the condition “meningitis” without having the actual disease. One will experience identical symptoms of meningitis without really having the illness.  This is yet another reason you should wear a medical identification bracelet.
• Changes in consciousness such as confusion or even coma.
• Headache. Headache is not always a symptom, but is noted as one of the possible symptoms.
• Irregular or poor muscles coordination.
• Nausea and vomiting.
• Heightened sensitivity to sound. (phonophobia)
• Heightened sensitivity to light. (photophobia)

Treatments for Hemiplegic Migraines

Because hemiplegic migraines are rare, many doctors have never treated anybody for the condition and are unsure about the right treatment.  It is best to educate yourself on the subject and seek the help of a migraine specialist who understands the disease path.  There are a lot of symptoms associated with hemiplegic migraines, and the symptoms are not the same in all patients, and for that reason they are much harder to treat or manage. 

The best treatment for familial hemiplegic migraines right now is medications such as NSAIDs and narcotic analgesics, which are focused on relieving the pain associated with the condition. A patient with hemiplegic migraine would not want to take any medications that are vaso- constrictors because there are concerns that this may cause a stroke.

With normal migraine, the onset is often due to external factors such as stress, diet, lack of sleep, etc. but with hemiplegic migraine this is a genetic neurological disorder that affects the amount of calcium moving into and out of the cells of the chromosome 1 and 19.  Because of this abnormal influx and efflux of calcium, this causes neurons to fire too easily which in turn causes the hemiplegic migraine. For this reason it has been found that calcium channel blockers can be an effective preventative strategy to the migraines. It is not likely that a change in diet or exercise or stress level will prevent a hemiplegic migraine attack.

Individuals who suffer from these types of migraines should wear some type of medical alert necklace or bracelet in case of the onset of the migraine and at which time the individual may be unable to convey his or her condition, and in which case bystanders are likely to call emergency responders, who will completely misinterpret the cause of the symptoms. It is likely the symptoms will be seen as a stroke or a vascular condition and treated as such. Wearing a medical identification bracelet or necklace will save a great deal of time in treating your symptoms.

Science is learning more about these types of migraines and trying to develop better medications to help individuals who suffer with familial hemiplegic migraines.  At this time it is suggested that the best method of treatment is in prevention methods such as the calcium channel blockers.  Prevention also begins with your family’s medical history to help in the process of diagnosis.

Read More: It's Now Possible To Zap Your Migraines Before They Start

Difficulties Diagnosing Hemiplegic Migraines

Because these types of migraines are rare and the symptoms often mimic other more common neurological disorders, diagnosing hemiplegic migraines can be very tough. This is why it is very important to have a clear family medical history in your medical chart so that doctors can rule out certain disorders as well as pinpoint disorders you share with other family members. 

It is also very important to tell your children of your condition so they can inform their doctors of the family history just in case they begin showing symptoms of the same disorder. It is possible to prevent your children from having a hemiplegic migraine if their doctors are aware of the family history and thus they can test and treat the disorder before it ever manifests itself in the form of an attack. 

Certainly familial hemiplegic migraine is the most traumatic of all migraines but the good news is they tend to lessen or even go away as you get older.  Understanding the disorder and knowing the chances that your children will also suffer from it is a huge benefit to them.  But familial hemiplegic migraines are still very poorly understood in the world of medical science, and research teams continue to try to figure out the causes and cures for this debilitating disorder. Hopefully as familial hemiplegic migraine becomes better understood science can develop treatments and possibly a cure to eliminate this disorder from ever effecting another generation. 

In the meantime, familial hemiplegic migraines can be managed — so if you believe you have symptoms, you would be advised to share your suspicions with your doctor.