Sporadic hemiplegic migraine (SHM) treatment may involve preventive oral medications that lower your likelihood of an attack. Migraine attacks usually require hospitalization and intravenous (IV) treatments.

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The primary goal of treating SHM is to manage your symptoms and avoid future attacks. This includes lowering the severity and frequency of migraine episodes, as well as relieving the short-term symptoms that develop during an attack.

This condition is rare, and research is limited, so treatment options are limited. This article will provide an overview of potential treatments for SHM.

Preventing hemiplegic migraine often involves two approaches: medication and lifestyle changes. Both may help reduce the frequency and severity of your migraine episodes.

Flunarizine

Flunarizine is a common type of preventive medication for other migraine disorders. Observations of its use in various types of migraine, including hemiplegic migraine, suggest that it might be a medication for doctors to consider when treating migraine. But more research is needed to confirm this. Common side effects included fatigue, weight gain, and mood changes.

Lamotrigine

Many people experience a visual aura during a hemiplegic migraine attack. A small, low quality 2020 study found that lamotrigine might help reduce or eliminate aura during a migraine attack. But this was not specific to hemiplegic migraine, and more research is needed.

Verapamil

A few small, low quality studies and case reports suggest that verapamil could help lower the burden of hemiplegic migraine. But evidence for its effectiveness in preventing migraine is lacking.

There has been little research into treatments for SHM. Most of the existing information comes from reports of single individualists, generally observations from doctors who’ve prescribed these medications to their patients. There are no medications specifically intended to treat this type of migraine.

Verapamil

Verapamil could help treat some people with SHM. This has been reported in a few cases but only when administered as an IV infusion. If you take this medication during an episode, it may help lower the severity of your migraine attack.

Flunarizine

Flunarizine may be effective in treating hemiplegic migraine episodes, especially in children. This would require hospitalization and an IV infusion.

Naloxone

According to a 2020 review, naloxone effectively lowered symptoms for two people with SHM. But the data on this drug and its effect on this condition is limited.

Steroids

During severe attacks, when someone is hospitalized and has had imaging done on their brain, doctors may recommend a course of IV corticosteroids.

If you have hemiplegic migraine, your doctor might advise you to avoid vasodilators, which are drugs that widen blood vessels. These medications may raise the risk of stroke-like symptoms, which can be a complication of hemiplegic migraine.

Triptans are a class of medications commonly used to treat standard migraine. But doctors do not generally recommend them for SHM. This is because these medications could potentially worsen the neurological symptoms associated with this condition.

Aside from typical medications, there are other steps you can take to help manage SHM.

Lifestyle changes

Lifestyle changes could help lower the frequency and severity of hemiplegic migraine. Doctors might recommend that you:

  • avoid known migraine triggers, such as physical exertion and bright light
  • maintain a regular sleep schedule
  • ensure that you do not sleep too little or too much
  • eat a nutritious, well-balanced diet
  • stay hydrated
  • manage your stress levels

Electrostimulation devices

Electrostimulation devices, which deliver a small electrical current to the nerves, might be beneficial for some people with migraine. These noninvasive devices are used on the skin’s surface and have minimal side effects.

Transcranial magnetic stimulation (TMS) may block some impulses in the brain that might be responsible for migraine aura.

Is SHM the same as hemiplegic migraine?

SHM can affect anyone. Hemiplegic migraine is thought to run in families, so you might inherit it from a biological parent. But both conditions cause the same symptoms.

Do hemiplegic migraine attacks ever go away?

Hemiplegic migraine might never go away entirely, but fewer attacks may happen as you grow older. And the severity may decrease.

Are hemiplegic migraine attacks similar to ministrokes?

Hemiplegic migraine attacks are different from strokes, and they’re not nearly as dangerous. But they can cause similar symptoms, such as weakness on one side of the body. If you’re experiencing these symptoms for the first time, you should always contact emergency services.

SHM is a rare type of migraine that causes neurological symptoms like weakness on one side. Because this type of migraine is so rare, there are no large studies into the best kind of treatment. But certain medications have been helpful for some people.

The treatment goal is to lower the intensity and frequency of migraine attacks. Lifestyle changes, such as stress management, may also help. Talk with a doctor about which treatment option might be right for you.