Hemiplegic Migraine

Curr Neurol Neurosci Rep. 2023 Jul;23(7):381-387. doi: 10.1007/s11910-023-01277-z. Epub 2023 May 29.

Abstract

Purpose of review: In this article, we review recent updates to the epidemiology, diagnostic testing, genetics, pathophysiology, and management of hemiplegic migraine.

Recent findings: While three genes have been historically associated with hemiplegic migraine, recent studies suggest two additional genes may also be implicated including PPRT2 and SLC1A3. Hemiplegic migraine is a severe subset of migraine with aura with symptoms including reversible hemiparesis in addition to other aura symptoms such as visual, sensory, or speech. The exact pathophysiology of hemiplegic migraine is not clear, but it is thought that this phenomenon is due to neuronal and glial depolarization causing cortical spreading depression. Due to the severity of presentation as well as the numerous mimickers, it is important to know a comprehensive differential and work-up. Given the low prevalence of the disease, most studies regarding treatment are limited to case studies. There is still an important need for further and larger studies regarding management of these cases.

Keywords: Familial hemiplegic migraine; Sporadic hemiplegic migraine.

Publication types

  • Review

MeSH terms

  • Epilepsy* / diagnosis
  • Hemiplegia / complications
  • Hemiplegia / diagnosis
  • Humans
  • Migraine Disorders* / diagnosis
  • Migraine Disorders* / epidemiology
  • Migraine Disorders* / genetics
  • Migraine with Aura* / diagnosis
  • Migraine with Aura* / epidemiology
  • Migraine with Aura* / genetics
  • Neurons