Which type of migraine do I have?

There are a number of different types of migraine headaches, including both classic and common migraine.  One particularly rare type of migraine is the hemiplegic migraine.

Hemiplegic migraines are migraine headaches with very particular symptoms.  They include:


* A sudden attack, unilateral (one-sided) weakness and/or paralysis, typically during the aura phase of migraine. 
* The weakness frequently involves a migraineur's face, arm, and leg. 
* When the right side of the body is the affected side, the migraineur may be speech impaired. 
* A mild head trauma can trigger a hemiplegic migraine. 
* A migraine headache follows the paralysis.
* The paralysis lasts from an hour to a day, but usually clears up within 24 hours. 
* Dizziness, vertigo, double vision, and difficulty in walking or balancing may all be part of hemiplegic migraine.


Hemiplegic migraines are predominantly genetic and sufferers usually have at least one first or second-degree relative (parent, sibling, aunt, uncle, first cousin) who also suffers from hemiplegic migraines.
Since many hemiplegic migraines are brought on by minor head trauma, people with a propensity for this type of migraine are encouraged to avoid contact sports.  In families where the condition is common, onset frequently occurs in childhood, so the no-contact rule is particularly important for children in hemiplegic prone families.


Several genetic markers have been identified specifically for hemiplegic migraines.  It is not a condition that screening is normally offered for, but screening is available for it upon request.
This type of migraine is particularly disturbing because its symptoms so closely resemble a stroke.  Fortunately, the stroke-like effects usually reverse completely within 24 hours.  They are also problematic because hemiplegic migraines do not respond to most migraine medications and often have to be treated more like epilepsy with more dangerous medications than regular migraineurs take.