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hemiplegic migraine
Familial & sporadic forms Eidemiology:
- rare
Clinical manifestations:
- migraine
- symptoms can last for hours to days, or rarely weeks
- most resolve completely
- aura (visual changes, numbness, paresthesias, dysarthria
- fever
- impaired consciousness, confusion to coma
- ataxia
- nausea/vomiting
- phonophobia
- hemiplegia
Differential diagnosis:
- TIA or stroke
Management:
- triptans & ergotamines are contraindicated because of vasoconstriction
- NSAIDs
- antiemetics
- opiates
- intranasal ketamine
- prophylaxis
- verapamil, acetazolamide, flunarizine, ketamine, lamotrigine naloxone have been used
- amitriptyline, topiramate, & valproic acid may be beneficial for migraine with aura
- beta-blockers generally avoided out of theoretical concern of ability of vessels to dilate
Specific
familial hemiplegic migraine
General
migraine headache
hemiplegia (HP)
References
- American Migraine Foundation: Hemiplegic Migraine
https://americanmigrainefoundation.org/resource-library/hemiplegic-migraine/
- IHS Classification ICHD-3
https://www.ichd-3.org/1-migraine/1-2-migraine-with-aura/1-2-3-hemiplegic-migraine/