Stroke vs. Hemiplegic Migraine


The symptoms of a hemiplegic migraine can be similar to the symptoms of a stroke. However, several specific factors differentiate the two.

Symptom differences

A stroke and hemiplegic migraine have several overlapping symptoms, including numbness or paralysis on one side of the body, communication difficulties, vision problems, headache, and dizziness.

One way to differentiate between a stroke and a hemiplegic migraine is the timing of the symptoms. If the symptoms come on very suddenly, it is more likely to be a stroke than a migraine. If they come on slowly and worsen over time, it is more likely to be a migraine.

Some symptoms of a stroke typically do not occur with hemiplegic migraines, including drooping of one side of the mouth (especially when smiling), hallucinations, trouble breathing, seizures, and behavioral changes, such as agitation.

Cause and risk factor differences

While the cause of hemiplegic migraines is not known, the biggest risk factor is having a family history of hemiplegic migraines. Abnormalities in four different genes have been linked with hemiplegic migraines, and they can be passed from parent to child. A child has a 50% chance of developing hemiplegic migraines if one parent has the condition. In addition to genetics, migraines can be triggered by environmental factors and hormonal changes.

The cause of a stroke is either a blockage in an artery leading to the brain or a burst/ leaking blood vessel in the brain. While having a family history of strokes is a risk factor, lifestyle choices, such as an unhealthy diet, inactivity, and alcohol or tobacco use are major risk factors.

Age is also a differentiating factor. Hemiplegic migraines often start in childhood or adolescence; whereas, strokes are more likely to occur after the age of 55.

Other differences

Treatment for a stroke vs. a hemiplegic migraine is dramatically different. Treatment for a stroke depends on the type but can include medications to prevent or promote blood clotting and surgery. Hemiplegic migraines are most often treated using migraine medications or anti-seizure medications.

A major difference between the two conditions is the long-term damage they can cause. Many strokes cause long-lasting or permanent damage involving strength and balance, thinking and reasoning, and communication. Long-term damage from hemiplegic migraines is extremely rare.

Since migraines, including hemiplegic migraines, can increase the risk of having a stroke, it is important to know the similarities and differences. Any individual who has not experienced a hemiplegic migraine before and experiences stroke-like symptoms should seek immediate medical care.