Q. I had a migraine yesterday morning and took my medication to get rid of it. It got rid of my pounding pain, but about 2 hours later a portion of the right side of my face became numb. Within another 3 hours, the entire right side of my face was numb, my mouth was drooping, and my right arm and leg were heavy. As you can imagine, we thought I could be having a stroke. I am 43. We went to the emergency room, and by the time I arrived, even my speech was affected. All CT scans came back clear. The doctors decided I was having a complex migraine and explained the headaches can present as though the patient is having a stroke. They gave me a migraine "cocktail" and massive steroids and within a half hour, my symptoms were much improved. I am still regaining more control even today. What was so odd was that I had no pain.  Have you heard of this kind of migraine before?

A rare and severe form of migraine was in the spotlight recently when Danny Spond, a Notre Dame linebacker, had to stop playing football after struggling with hemiplegic migraine for the last year. 120901-N-WL435-990   Spond hopes to continue as a linebacker coach for the Fighting Irish, but his departure and a statement from team physician, Jennifer Malcolm, MD, indicated just how disabling this form of migraine can be.

I have suffered Basilar Artery Migraines which I was diagnosed with, but after reading articles from The National Headache Foundation I believe that I should be diagnosed with Hemiplegic migraine. Although I still do not totally fall into this category. I started suffering with this type of migraines from the age of 13, where I started my periods, and after suffering epileptic seizures since I was 2 years old. My grandfather and father had them and then I developed them----but they were of a more intense version. A couple of days before I get a seizure, I start to experience chest pain, on and off until the attack starts.

By Anne Walling, M.D. Professor, Family and Community Medicine, University of Kansas School of Medicine – Wichita THE CASE Al was a very healthy 28-year-old lawyer. The only indication of a potential health problem was a history of migraine in his mother and several family members. Al himself had never suffered from headaches. One day at work, Al felt unusually tired and had trouble concentrating. He found writing difficult and noticed he was “dropping things and tripping over my feet.” At the insistence of his boss, Al made an emergency appointment with his family physician. By then he had developed a headache on his left side and felt nauseated and tired. His arm and leg were weaker on the right side than the left. A neurological assessment, including MRI and other tests, was performed because of the possibility of a stroke. The tests were normal, but while they were being completed, Al appeared to have a typical left-sided migraine. The weakness disappeared as the headache, nausea and exhaustion progressed. After taking pain pills and a long nap, Al was completely back to normal within a few hours. Al’s physicians concluded that the weakness was a migraine aura.

Hemiplegic Migraine: An Unusual Type of Migraine With Aura

By Jonathan Gladstone, M.D. FRCPC, Gladstone Headache Clinic Toronto, Canada THE CASE Since she was 13, Terri has been experiencing migraine without aura approximately 1-2 times per month. Terri, who is now 21, also gets migraine with visual aura a few times per year and, on several occasions, has experienced migraine with a sensory aura (numbness/tingling up one arm and into her face). However, over the last 18 months, she has had five more dramatic episodes in which she experienced pronounced weakness/paralysis on one side of her body (leg, arm, and face) together with sensory symptoms (numbness/tingling on the same side of the body) and/or visual symptoms (blurriness/loss of vision on one side). The weakness can last up to 12 hours and has led to Emergency Department visits on each occasion, with co-workers, family members, and Terri herself concerned that she could be suffering a stroke. CT scans and MRIs of her brain have been normal, ruling out a stroke. She was sent for tests of her heart and the blood vessels in her neck as well tests to determine if her blood was prone to form clots. All came back normal. Terri was eventually referred to a headache specialist. Review of her family history found that her mother and maternal grandmother had similar symptoms, particularly as teenagers and young adults. Their attacks eventually became less frequent and disappeared by menopause. The neurologist was intrigued by this family history and the significant and prolonged attacks of weakness. She wondered about a diagnosis called familial hemiplegic migraine and ordered the newly available genetic tests for this disorder. Interestingly, genetic testing confirmed that Terri did indeed have familial hemiplegic migraine. Terri's unusual events were finally explained and she was placed on a preventive medication in an attempt to decrease the frequency and/or severity of her attacks.

Q. I was diagnosed with migraine syndrome after a hospital admission with aura, inability to speak and blood pressure of 200/99. Until this experience I was a person who had never had blood pressure above 120. That was three years ago when I was 65 years old. I was put on one aspirin a day and since have had only two slight auras and no other symptoms, except an onset of high blood pressure that my internist is attempting to control with medications, all of which give me side effects I cannot tolerate. My blood pressure fluctuates from very high to very low during a migraine attack. My doctors don't believe they are related, but one doesn't happen without the other. They are treating me for heart trouble with migraines on the side. My question: could this high blood pressure be related to the migraine syndrome, and if so what can I do to overcome it? My diet is a healthy one and I exercise 4-5 times a week. I do not want to be on medications, as I have always been very sensitive to drugs, but of late I can't see an alternative. Is there one?