Hemiplegic migraine FAQs

By: Rachel Baxter, Communications Officer, The Migraine Trust

18th May 2022

In this blog we answer common questions about hemiplegic migraine. For general information on symptoms, causes, diagnosis and treatment, visit our hemiplegic migraine information page.

How long does a hemiplegic migraine attack last?

A migraine attack tends to last between four hours and three days, but some people might find it lasts longer. A key symptom of hemiplegic migraine is temporary weakness down one side of the body, which tends to last between one and 24 hours, although it might linger for a few days.

Can you have hemiplegic migraine without a headache?

Yes, it is possible to have a hemiplegic migraine attack without a headache. Some people find a headache appears once other symptoms like aura and temporary weakness have subsided, but this is not always the case. Other people might get a headache before their other symptoms, however, not everyone gets a headache. It’s important to tell the doctor all of your symptoms to help them make an accurate diagnosis.

Can hemiplegic migraine be cured?

Unfortunately, there is currently no cure for hemiplegic migraine. Treatment will vary from person to person, so if you suspect you have hemiplegic migraine or have already been diagnosed with it, your doctor will be able to decide which treatment option is best for you. It’s likely you will be given a preventive medication such as topiramate.

Are hemiplegic migraine attacks dangerous?

Hemiplegic migraine symptoms, which include weakness down one side of the body, speech difficulties and confusion, can be quite extreme compared to other types of migraine. An attack can be frightening for the person experiencing it, especially if it’s their first attack. Many people become worried because the symptoms can be quite similar to those of a stroke. However, hemiplegic migraine itself is not the same as a stroke and very rarely dangerous. Hemiplegic migraine is also treatable.

If you have new or different symptoms or you think you could be having a stroke, it’s important to seek medical attention just in case. Hemiplegic migraine attacks generally come on slowly while a stroke tends to be sudden. Learn more about migraine and stroke and their symptoms here.

Should I go to the emergency room with hemiplegic migraine?

Your doctor or specialist will be able to advise you on what to do when you’re experiencing a hemiplegic migraine attack and when you might need to seek medical attention, so it’s worth asking them about it at your next appointment.

If you’re experiencing your usual migraine symptoms and feel you can manage them at home then it’s unlikely you need to seek medical help. If you experience sudden unexpected new symptoms during an attack or you feel unsure about whether you’re experiencing a migraine attack or something else then it may be worth visiting A&E to rule out anything else. You can also call the NHS helpline on 111 if you’re unsure about what to do. They will ask about the symptoms you’re experiencing and advise you.

Can you drive if you have hemiplegic migraine?

You should not drive at all during a hemiplegic migraine attack. If you can feel one coming on, you should pull over as soon as you can. If you’ve been prescribed acute migraine medication, you should take it as soon as possible.

Having migraine doesn’t mean you can’t drive at all, but if your attacks are sudden and disabling or are likely to be a source of danger to the public, then you should inform the DVLA (or DVA if you’re in Northern Ireland). You should also let them know if your migraine then worsens.

If you’re unsure about whether you need to contact the DVLA or DVA, or whether you should be driving, it’s worth speaking to your doctor. They will be able to advise you on what to do based on your migraine symptoms. You can also contact the DVLA Medical Enquiries team or the DVA for more information and guidance.

If you’re unable to drive due to your migraine, you may be able to access support and public transport discounts to help you get around. Find out more here.

Is hemiplegic migraine a disability in the UK?

In the UK, migraine is sometimes classed as a disability under the Equality Act 2010. Whether it is depends on how severe it is. A disability is defined as a physical or mental impairment that has a ‘substantial’ and ‘long-term’ negative effect on your ability to do normal daily activities. So, if your migraine is having a big impact on your life, such as affecting your ability to work, look after your family and take part in everyday activities, over a period of months or years, your migraine may be classed as a disability. Hemiplegic migraine may also be more likely to be considered a disability under the Equality Act 2010 than some other types of migraine as its symptoms are particularly disabling.

To confirm whether you are covered under the Equality Act 2010, speak to your doctor, specialist or occupational health practitioner and they’ll be able to give their opinion. The Act protects people with disabilities from discrimination – for example, it protects you from being discriminated against at work due to your migraine.

Read about Abigail’s experience of living with hemiplegic migraine here. Learn more about the different types of migraine and their symptoms here.