What should you know about hemiplegic migraine?

A hemiplegic migraine may involve weakness or heaviness in the face, arm or leg on one side, followed by or alongside headache. Aura can also cause flashing lights, tingling, difficulty finding words, dizziness or altered sensation. Nausea, vomiting and sensitivity to light may occur. Symptoms can resemble a stroke, especially when they begin suddenly. A previous diagnosis does not make every future episode safe to self-diagnose; a changed pattern deserves review.

Stop driving and rest somewhere safe. Note the exact time symptoms began, which side is affected, and whether speech, vision, balance or alertness changed. Follow your personal treatment plan if a clinician has provided one, and do not start a new medicine without advice. Regular sleep, meals, hydration and a record of triggers may help future assessment. Related symptoms include Headache, Dizziness, Light Sensitivity, Nausea, Vertigo and Vomiting.

Call emergency services for first-time weakness, facial drooping, trouble speaking, severe confusion, fainting, seizure, new vision loss, or a sudden severe headache. Seek urgent help if symptoms do not improve as expected, are different from previous attacks, follow a head injury, or occur with fever and a stiff neck. Do not wait for a headache to develop before seeking help.

How can we distinguish my episodes from stroke or another cause? What should my written emergency plan say? Which medicines are suitable during an attack? Should I see a neurologist, and what symptoms should prompt immediate help?