medication and hemiplegic

I have seen three different doctors about my headaches and they have all told me the same thing, that I can not take the "normal" migraine medication for pain,due to the fact that I have hemiplegic migraines.They have all told me that I am to use Morhpine for pain control, which I have been on for the last five years. I use this medication when I have a flare up and do not use it if my headaches are under control. On my last admission to hospital I had a new nurse who has decided that I am not to no longer be using this drug for migraines and has made it very hard for me when i have a bad flare up.There are times with my headaches I am admitted to hospital as my right side loses all the feeling in it,and I recieve my pain control by injection until the feeling returns. This is the treatment plan by three neurologists,and I wonder what your out look on this would be.   Thank you

[Vanessa Lacuesta]

Hi,

I understand your concern.

Let me ask which type of hemiplegic migraine do you have?

There are two types, the familial and the sporadic type.The familial type is associated with a genetic mutation in the genes encoding for the calcium channel which may help explain the symptoms of hemiplegic migraines. The sporadic type may present similarly without the similar genetic basis of familial hemiplegic migraines.

The usual medications for migraines such as the triptans are contraindicated for hemiplegic migraines. The use of symptomatic treatment ( such as pain relievers and anitiemetics) may play an important role. Preventive migraine therapy especially the use of calcium channel blockers may be essential in controlling the attacks of this type of migraine especially that of the familial type.

A study has shown that sporadic hemiplegic migraines may be responsive to calcium channel blocker therapy (http://www.neurology.org/cgi/content/abstract/60/1/120).You may want to discuss this with your physician. the role of abortive migraine therapies with triptans and ergotamines is still being continually investigated.

Does this type of migraine run in your  family?

[kari70]

My Neurologist Dx me with Sporadic hemiplegic migraine with paralysis on leftside with facial droop lasting three weeks.My arm and left leg started responding after the increase dose of calcium blocker. Also, I was put on Topmax for prevention of Migraines. After 4 weeks, I have had 24 hour paralysis and facial droop switch to right side. During this time
my family thought I had a seizure. Is this Dx ever under control?  

[Vanessa Lacuesta]

Hi,

I think you are managed well given that the more conventional medications for migraines are not used for managing hemiplegic migraines. I think you are on the right track. This type of migraine headaches may be controlled but the onset of attacks may never be predictable. I suggest that you have to inform your colleagues and friends of your condition so they may be able to assist you. You may ask your physician if you may be given a card or ID wherein all information about your condition may be provided in case of an attack.With proper management and evaluation, hemiplegic migraines may be controlled .

[nola606]

Try sibelium for your hemiplegic migraines.  It is a calcium channel blocker which is very effective for this type of migraine.  I have been on it for six years and it has helped my episodes a lot.  The side effects are possible depression and weight gain but if you can cope with the weight gain and are not prone to depression they might be worth a try.