Anxiety, stress, and strong emotions can all play a role in triggering a hemiplegic migraine attack. Genetic factors also indicate an association between hemiplegic migraine and anxiety.

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Anxiety is one potential trigger for a hemiplegic migraine attack. Research also suggests a possible shared genetic predisposition for hemiplegic migraine and anxiety. Other factors, such as environmental triggers, can also contribute to the onset of a hemiplegic migraine attack.

Various factors can trigger hemiplegic migraine, including many related to anxiety.

Stressful event

A stressful event, such as a major life change or trauma, could trigger a hemiplegic migraine attack if you are predisposed to the condition. Chronic stress at work or at home could also increase your risk of hemiplegic migraine.

Interestingly, studies show that in mice with familial hemiplegic migraine, stress relief after a period of chronic stress seems to increase the risk of migraine attacks. The study mentions that this could explain why people tend to have episodes during periods of stress relief like weekends.

Strong emotions

Powerful emotions like anxiety, depression, and intense worry can trigger hemiplegic migraine episodes.

Lack of sleep

There’s evidence showing a relationship between migraine and sleep, which includes lack of sleep, too much sleep, and insufficient deep sleep. Research suggests that lack of sleep could potentially trigger hemiplegic migraine attacks, although more research would help understand this connection better.

Physical stress and exertion

Physical stress, such as excessive physical exertion, may trigger hemiplegic migraine, including other forms of physical stress, like injury or trauma.

Hemiplegic migraine is rare, and research about its causes and triggers is limited. But some small studies shed light on a possible connection between hemiplegic migraine and anxiety.

Genetic factors

Studies show that certain genetic factors can increase your risk of both hemiplegic migraine and anxiety.

A 2021 study confirmed abnormalities in the ATP1A2 gene in a family with familial hemiplegic migraine type II. The same gene contributes to anxiety.

Psychiatric manifestations

According to older reports from 1999, there are cases where people with familial hemiplegic migraine also experience co-occurring psychiatric conditions, including episodes of acute paranoid psychosis and anxiety.

Observations from a 2016 study show that people with hemiplegic migraine may have co-occurring anxiety and obsessive-compulsive disorder.

Depression and anxiety

A 2016 study involving 89 participants with hemiplegic migraine found that the participants had a higher rate of depression than the control group. The study suggests a predisposition for mental health issues like depression and anxiety.

Preventing a hemiplegic migraine attack might not be possible due to its complex nature and genetic origins. But certain strategies may help manage and potentially reduce the frequency of these attacks.


One approach to preventing hemiplegic migraine involves medication. Preventive options may include:

Depending on the frequency and severity of your attacks, and overall health, your doctor may prescribe a combination of these medications.

Greater occipital nerve block

Greater occipital nerve (GON) block is a procedure where your doctor injects a local anesthetic into the back of your head to block pain signals. A 2021 review looked at numerous studies on GON and types of migraine. It mentions a few studies that found GON successful in reducing hemiplegic migraine symptoms.

More extensive research will determine whether GON effectively prevents hemiplegic migraine.

Avoiding triggers

Understanding and avoiding your triggers can be key in managing and reducing your hemiplegic migraine episodes. Keeping a journal may be helpful in identifying your migraine triggers. Your doctor can guide you on how to eliminate triggers once they’re identified.

Here are some frequently asked questions about hemiplegic migraine attacks.

What makes hemiplegic migraine worse?

Hemiplegic migraine may worsen when you’re exposed to certain triggers such as stress and lack of sleep.

How rare is a hemiplegic migraine?

Hemiplegic migraine is a rare type of migraine, affecting only about 0.01% of the population.

Are hemiplegic migraine episodes like seizures?

While hemiplegic migraine and seizures can cause similar symptoms like jerky movements or loss of consciousness, they are distinct conditions. But some people with specific genetic mutations may experience both.

There is a key relationship between anxiety and hemiplegic migraine. But it’s not the only trigger.

Genetic mutations can increase your risk of this type of migraine. If you receive a diagnosis of hemiplegic migraine, consider speaking with your doctor about your triggers and how to avoid them.