Familial Hemiplegic Migraine: Causes, Diagnosis and Treatment

Written by Medicover Team and Medically Reviewed by Dr Krishna Haskar Dhanyamraju , Neurologists

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1. Causes 2. Find a Doctor 3. Diagnosis 4. Treatment 5. FAQs

Familial hemiplegic migraine (FHM) is a rare inherited type of migraine with aura that causes temporary muscle weakness or paralysis on one side of the body before or during a migraine attack. Other symptoms may include severe headache, vision changes, numbness, speech difficulties, and dizziness. Early diagnosis and appropriate treatment help reduce attack frequency, manage symptoms, and improve quality of life.

What are the Types of Familial Hemiplegic Migraine?

Familial Hemiplegic Migraine (FHM) is a rare genetic neurological disorder that runs in families. There are different types or forms of FHM, each associated with specific genetic mutations.

These mutations affect the ion channels in the brain, leading to migraine symptoms along with temporary weakness on one side of the body. Understanding the various types of FHM is crucial for accurate diagnosis and appropriate management of this condition.

FHM1: Familial Hemiplegic Migraine type 1 is caused by mutations in the CACNA1A gene, leading to severe aura symptoms like temporary paralysis on one side of the body.
FHM2: Familial Hemiplegic Migraine type 2 is linked to mutations in the ATP1A2 gene, resulting in similar symptoms to FHM1 but with different genetic origins.
FHM3: Familial Hemiplegic Migraine type 3 is associated with mutations in the SCN1A gene, leading to hemiplegic migraine episodes and potential seizure activity.
FHM4: Familial Hemiplegic Migraine type 4 is a rare subtype caused by mutations in the PRRT2 gene, resulting in episodes of hemiplegic migraine along with other movement disorders.
FHM5: Familial Hemiplegic Migraine type 5 is a recently identified subtype with genetic mutations in the SLC4A4 gene, leading to hemiplegic migraine attacks and potentially other neurological symptoms.

What are the Symptoms of Familial Hemiplegic Migraine?

Familial Hemiplegic Migraine is a rare type of migraine with distinct symptoms that can vary among individuals. People affected by this condition typically experience specific symptoms that set it apart from other types of migraines.

These symptoms usually involve neurological manifestations and can be debilitating. Understanding these symptoms is crucial for proper diagnosis and management of Familial Hemiplegic Migraine.

Severe headache.
Temporary weakness on one side of the body.
Visual disturbances.
Nausea and vomiting.
Sensory changes.
Difficulty speaking or understanding speech.

What are the Causes of Familial Hemiplegic Migraine?

Familial hemiplegic migraine is a rare type of migraine that has a genetic component. The main causes of this condition include genetic mutations that affect ion channels in the brain, specifically calcium and sodium channels.

These mutations can disrupt the normal functioning of the brain cells, leading to the symptoms of hemiplegic migraine. Other factors that may contribute to the development of familial hemiplegic migraine include environmental triggers and lifestyle factors.

Genetic mutations.
Changes in calcium channels.
Disruption in neurotransmitter release.
Abnormalities in ion channels.

When to See a Doctor for Familial Hemiplegic Migraine?

Episodes of severe headache accompanied by one-sided weakness, speech difficulties, or visual changes should be evaluated by a neurologist, especially if there is a family history of hemiplegic migraine. Early assessment helps distinguish the condition from a stroke and guides appropriate treatment.

You should see a doctor if you have:

Recurring migraines with temporary weakness or numbness.
Difficulty speaking or vision changes during headaches.
Increasing frequency or severity of migraine attacks.
A family history of Familial Hemiplegic Migraine.

Get medical help immediately if:

Sudden one-sided weakness or paralysis.
Loss of consciousness or seizures.
A severe headache unlike any previous migraine or symptoms suggestive of a stroke.

These could be signs of a serious complication like Familial Hemiplegic Migraine, which needs urgent care.

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How Is Familial Hemiplegic Migraine Diagnosed?

To diagnose Familial Hemiplegic Migraine (FHM), healthcare providers consider symptoms reported by the patient. They may also review the individual's medical history to check for any patterns of migraines or related conditions within the family.

Additionally, doctors may perform a physical examination and run specific tests to rule out other potential causes of symptoms. The diagnosis of FHM is typically based on a combination of these factors to determine the presence of this specific type of migraine disorder.

Genetic testing
Neurological examination
Imaging tests (MRI, CT scan)
Blood tests
Electroencephalogram (EEG)

What are the Treatment for Familial Hemiplegic Migraine?

Familial Hemiplegic Migraine (FHM) is a rare genetic type of migraine that can cause temporary paralysis on one side of the body. Treatment for FHM focuses on managing symptoms and preventing attacks.

Medications: Doctors may prescribe medications to help manage symptoms and prevent future episodes of Familial Hemiplegic Migraine.
Lifestyle Changes: Making healthy lifestyle choices like getting enough sleep, reducing stress, and avoiding triggers can help prevent or reduce the frequency of migraines.
Biofeedback Therapy: Biofeedback therapy can help individuals learn to control certain bodily functions to reduce the intensity and frequency of migraines.
Cognitive Behavioral Therapy (CBT): CBT can be beneficial in managing stress, anxiety, and depression associated with migraines, which may help reduce the severity of episodes.
Genetic Counseling: Genetic counseling can provide information about the condition, inheritance patterns, and potential risks to family members, aiding in making informed decisions about managing Familial Hemiplegic Migraine.

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What are the Risk Factors of Familial Hemiplegic Migraine?

Familial Hemiplegic Migraine is a rare type of migraine that can run in families. Certain factors can increase the risk of developing this condition. These risk factors are associated with genetic mutations that affect the nervous system. Understanding these risk factors can help in identifying individuals who may be more likely to experience Familial Hemiplegic Migraine.

Genetic predisposition.
Family history of migraines.
Certain gene mutations.
Environmental triggers.
Gender (more common in females).

What is the Recovery Process for Familial Hemiplegic Migraine?

Recovery focuses on managing episodes and preventing future attacks, as this is a lifelong genetic condition.

Identifying and avoiding personal triggers.
Following prescribed medications regularly.
Maintaining a healthy lifestyle and stress control.
Regular follow-up with a healthcare provider.

Frequently Asked Questions

1. What is Familial Hemiplegic Migraine (FHM)?

Familial Hemiplegic Migraine is a rare form of migraine with aura that runs in families and can cause temporary paralysis or weakness on one side of the body.