Hemiplegic Migraine: Symptoms, Diagnosis and Treatment
Hemiplegic migraine is a rare type of migraine with aura that causes temporary weakness on one side of the body. Because it can look like a stroke, getting the right diagnosis matters.
What is hemiplegic migraine?
“Hemiplegic” means affecting one side of the body. In this type of migraine, one side of the body becomes weak during an attack. The weakness is a kind of aura (a set of temporary nervous-system symptoms), and it usually comes along with more familiar aura symptoms such as vision changes, numbness or trouble speaking. The headache and other symptoms are often much like those of other migraine attacks.
There are two forms:
- Familial hemiplegic migraine runs in families.
- Sporadic hemiplegic migraine happens in someone with no family history of it.
Researchers are still studying the genetics behind it.
Common symptoms
The main symptoms are:
- Weakness on one side of the body
- Headache
- Other aura symptoms: vision changes, numbness, tingling or trouble speaking
Some people also have:
- Fever
- Changes in alertness, from confusion to, in severe cases, coma
- Problems with coordination
- Nausea or vomiting
- Sensitivity to light and sound
Symptoms can last for hours or days, and in rare cases for weeks. In most people, they go away completely.
What can trigger it
The American Migraine Foundation (AMF) lists these common triggers:
- Certain foods or smells
- Lights
- Stress
- Too little or too much sleep
- Physical activity
- Head injury
Some attacks happen with no trigger you can identify.
How it is diagnosed
Hemiplegic migraine can look a lot like a stroke, a seizure or other serious brain conditions. That is why a careful workup matters. Diagnosis usually includes:
- A detailed look at your medical history and your family’s history, especially of headache and migraine
- A full neurological exam
- Scans of the brain and blood vessels, when needed, to rule out other causes
Because it is so rare, people are often referred to a headache specialist.
Treatment options
Treatment is planned with your doctor and usually has two parts.
During an attack: options the AMF names include anti-inflammatory pain relievers (NSAIDs) and medicines for nausea. A nasal spray form of ketamine may shorten aura in some people. Triptans and ergotamines, two common migraine medicine groups, are currently not recommended for hemiplegic migraine because they narrow blood vessels and may raise stroke risk. The AMF notes that a newer class of migraine medicine works without narrowing blood vessels and may be an option your doctor considers.
Prevention: most patients and their doctors use preventive treatment. Medicines used to prevent typical migraine with aura may help. A plan may include daily medicine, supplements or lifestyle changes.
What patients say
5.0 from 21 Google reviews
★★★★★
Dr. Park is AMAZING!!! My son has had terrible migranes for over 20 years. They have impacted his life severely. He has been to every doctor and specialist. He has taken many different medications with no relief. He has done all the hands on manipulations available with no relief. I found Dr. Park online and booked an appointment for him. He did not want to go because he has been to so so many other doctors. And she is about an hour from us, but from day 1 he had gotten positive results. Dr. Park is the first doctor who actually told us that they were hemiplegic migranes. That is the type that mimic a stroke. They are very scarey. The results from the treatments from Dr. Park have been life changing for him. It won't eliminate the migranes but they have been far less in occurance and far less in intensity. Dr. Park is the first and only doctor that has had any impact on his migraines. We would travel anywhere to see her. I also know that it can be a hardship that she does not take insurance. I actually like that because the insurance often dictates what she can do and how often. The cost is also much lower because you don't have to go through insurance. Dr. Park has truly changed his life and that is worth everything!
Reviews are shared from Google in the patients’ own words. Individual experiences vary.
How Dr. Park can help
Dr. Hannah Park is a dual board-certified, fellowship-trained headache medicine neurologist with over 10 years of specialized experience, and hemiplegic migraine is among the conditions she treats. Your first visit is a 90-minute consultation with Dr. Park: a full history review, a neurological exam, a diagnosis and a personalized treatment plan.
The practice focuses on targeted injection treatments, such as an occipital nerve block or a peripheral nerve injection, rather than a cycle of prescription medicines, and it does not prescribe opioids. See services and fees. Appointments are Monday to Friday, 9 a.m. to 6 p.m.
When to get emergency care
If weakness develops with a headache, get medical help right away. Do not assume it is migraine. Call 911 or go to the nearest emergency room for new or sudden weakness on one side of the face or body, numbness, trouble speaking, vision changes, trouble walking, or symptoms that feel different from your usual attacks or last much longer.
Related
Sources
This page summarizes patient information from these organizations, in our own words. It is general education, not medical advice.
- Hemiplegic Migraine: Symptoms and Treatments, American Migraine Foundation
- Understanding Migraine With Aura, American Migraine Foundation
- Migraine in the Emergency Department: When to Go to the ED for Migraine, American Migraine Foundation
Last updated October 27, 2026.
Living with hemiplegic migraine? Plan your care with a specialist.
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