hemiplegic migraine: a plain-language guide built from published research

Please read this first. This guide is a companion to your medical team, not a replacement, and it is not medical advice. Everything here is tied to published research. If something you expected is not here, it almost always means we have not mapped a source for it yet, not that it is unknown to medicine. hemiplegic migraine is an early, growing map, so it will look incomplete on purpose: we would rather show less and have every line be something you can check than fill the page with claims we cannot stand behind. For anything about your own situation, your clinicians hold the full picture. How this guide is built and why.

What it is

Hemiplegic migraine is a rare and severe form of migraine with aura whose defining feature is temporary weakness on one side of the body during an attack. The familial form is inherited in an autosomal dominant pattern.

Signs and symptoms

Diplopia

Double vision (diplopia) can occur during attacks in some people, among the broader range of aura symptoms.

Limited evidenceSource: ORPHA:569

Evidence ratingweak

Study designontology_import

Confidence (0-1)0.7

Replicationunreplicated

Supporting sourcesPMID:42067833

Notesplain_language confirmed from PMID:42067833 via curation 2026-06-12.

Last reviewed2026-06-12

Aphasia

Difficulty with speech and language (dysphasia or aphasia) can occur during an attack as one of the aura symptoms.

Limited evidenceSource: ORPHA:569

Evidence ratingweak

Study designontology_import

Confidence (0-1)0.7

Replicationunreplicated

Supporting sourcesPMID:41146775

Notesplain_language confirmed from PMID:41146775 via curation 2026-06-12.

Last reviewed2026-06-12

Migraine with aura

Hemiplegic migraine is a form of migraine with aura: the headache comes with temporary neurological symptoms that build up and then resolve.

Limited evidenceSource: ORPHA:569

Evidence ratingweak

Study designontology_import

Confidence (0-1)0.7

Replicationunreplicated

Supporting sourcesPMID:41885191

Notesplain_language confirmed from PMID:41885191 via curation 2026-06-12.

Last reviewed2026-06-12

Hemiparesis

Hemiparesis, partial weakness of one side of the body, can develop during an attack, sometimes alongside headache and speech difficulty over a day or two.

Limited evidenceSource: ORPHA:569

Evidence ratingweak

Study designontology_import

Confidence (0-1)0.7

Replicationunreplicated

Supporting sourcesPMID:41146775

Notesplain_language confirmed from PMID:41146775 via curation 2026-06-12.

Last reviewed2026-06-12

Hemiplegia

Hemiplegia, weakness or paralysis affecting one whole side of the body, can occur as an aura symptom during attacks and is the defining feature of this migraine type.

Limited evidenceSource: ORPHA:569

Evidence ratingweak

Study designontology_import

Confidence (0-1)0.7

Replicationunreplicated

Supporting sourcesPMID:42193281

Notesplain_language confirmed from PMID:42193281 via curation 2026-06-12.

Last reviewed2026-06-12

Treatment and management

What the research describes, not a recommendation. Treatment decisions belong with your clinician.

This covers treatments that appear in the published research mapped here. Investigational and experimental therapies are not included, so their absence is a boundary of this map, not a sign they do not exist.

Verapamil

Verapamil, a calcium-channel blocker, is recommended as a preventive treatment for familial hemiplegic migraine and may also help in the sporadic form.

Used to help with: Familial or sporadic hemiplegic migraine.

Limited evidenceSource: PMID:17032572

The source text this rests on

“Oral verapamil is recommended for patients with familial hemiplegic migraine and may be effective in patients with sporadic hemiplegic migraine.”

An excerpt quoted verbatim from the source named above, shown as recorded. The full sentence is in the linked source.

Evidence ratingweak

Confidence (0-1)0.7

Replicationunreplicated

Notesconfirmed from PMID:17032572 via curation 2026-06-12

Last reviewed2026-06-12

Turn this into questions for your doctor

The hardest part is often knowing what to ask. PatientLead Health helps families turn what is on this page into the right questions for their care team.

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How to read the evidence labels

Widely acceptedSpecialists broadly agree on this.

Strong evidenceBacked by solid, repeated research.

Moderate evidenceReasonable evidence, still being confirmed.

Limited evidenceSome evidence, but not yet convincing.

Early evidenceAn early finding that needs more study.

Experts disagreeResearchers actively disagree about this.

Where this comes from

This guide is built from 2 published source(s). Every claim above links back to one of them. Click any source ID to read the original on PubMed.

ORPHA:569 · Orphanet/HPO annotations for Familial or sporadic hemiplegic migraine

PMID:17032572 · Interactions between migraine and stroke.