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Suggest treatment for hemiplegic migraine

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Posted on Thu, 12 May 2016
Question: diagnosed last week with hemiplegic migraine. L sided neurological signs now 8 days. ct and mri scan clear
could it be anything else?
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Answered by Dr. Neeraj Kumar (23 minutes later)
Brief Answer:
Possibility of hemiplegic migraine

Detailed Answer:
Hello,
I have gone through your question and understand your concerns.
The familial type of hemiplegic migraine has positive family history too.
The hemiplegic migraine should be considered if a patient is a case of migraine with aura and having these episodes of weakness which are transient and improves in few days.
The onset of weakness is usually preceded by migraine headache.
The neuroimaging may be normal and rules out stroke.
For treatment you can take pain killers and avoid Triptans used in acute migraine attacks.
For prophylaxis of further attacks Flunarizine, Topiramate or other calcium channel blockers may be used.
Wishing you good health and early recovery
Do get back to me for further queries.
Regards
Dr N Kumar
Neurologist
Above answer was peer-reviewed by : Dr. Yogesh D
doctor
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Follow up: Dr. Neeraj Kumar (25 minutes later)
yes it was preceeded by a headache. Now that it it is persisting for more than a week I am concerned that this is very unusual. The area of weakness is of the hypoglossal nerve left and some numbness of left face. I also have neck pain.
please tell me if there is anything else it could be
doctor
Answered by Dr. Neeraj Kumar (13 minutes later)
Brief Answer:
Other diagnosis considered if additional symptoms

Detailed Answer:
Hello,
If you are a known case of migraine then possibility of hemiplegic migraine is to be considered.
Other diagnosis can be transient ischaemic attacks which usually recovers soon mostly within an hour.
In presence of fever, viral illness, Nerve involvement may be considered.
Other possibilities require presence of fever, vomiting, seizure, visual complains, loss of consciousness.
If only weakness preceded by migraine like headache is the symptom then hemiplegic migraine should be considered.
Regards
Dr N Kumar
Neurologist
Above answer was peer-reviewed by : Dr. Yogesh D
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Answered by
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Dr. Neeraj Kumar

Neurologist

Practicing since :2006

Answered : 2263 Questions

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Suggest treatment for hemiplegic migraine

Brief Answer: Possibility of hemiplegic migraine Detailed Answer: Hello, I have gone through your question and understand your concerns. The familial type of hemiplegic migraine has positive family history too. The hemiplegic migraine should be considered if a patient is a case of migraine with aura and having these episodes of weakness which are transient and improves in few days. The onset of weakness is usually preceded by migraine headache. The neuroimaging may be normal and rules out stroke. For treatment you can take pain killers and avoid Triptans used in acute migraine attacks. For prophylaxis of further attacks Flunarizine, Topiramate or other calcium channel blockers may be used. Wishing you good health and early recovery Do get back to me for further queries. Regards Dr N Kumar Neurologist