Hemiplegic Migraine

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

Automated summary

This article provides a review of the recent updates in the epidemiology, diagnostic testing, genetics, pathophysiology, and management of hemiplegic migraine. Recent studies have identified two additional genes (PPRT2 and SLC1A3) that may be implicated in hemiplegic migraine, in addition to the three historically associated genes. Hemiplegic migraine is a severe form of migraine with aura that includes reversible hemiparesis and other aura symptoms. Understanding the comprehensive differential diagnosis and work-up is crucial due to the severity of the condition and the presence of mimickers. Further and larger studies are needed to explore the management of these cases.