Familial hemiplegic migraine

What is the prognosis for memory retention when an individual with familial hemiplegic migraine (FHM) is on Topamax?

The benefits and/or limitations of Topamax in treating individuals with FHM have not been well studied. We were not able to find information in the medical literature specifically noting an effect on memory retention. More research is needed to determine whether this medication has a positive impact on this symptom.

Last updated on 05-01-20

Will the side effects of Topamax (Topiramate) resolve in individuals with familial hemiplegic migraine (FHM)?

Topamax associated side effects are reported to occur in approximately 70% of individuals prescribed the medication for prevention (prophylaxis) of migraines. The most commonly reported side effects are a burning or prickling sensation in the hands, legs or feet (paresthesia), fatigue, nausea, difficulties with concentration, taste disturbance, and weight loss. Topiramate may cause other side effects as well. For a full list of side effects, visit the page on Topiramate provided by MedlinePlus, a resources through the National Library of Medicine.

These side effects occur most frequently during times of medication adjustment and lead to discontinuation of use in about 30% of cases. We unfortunately were not able to locate information in the medical literature describing the amount of time these symptoms are typically present while using this medication. As with any side effects caused by medications, we recommend you discuss your concerns with your prescribing physician.

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online (http://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088).

Last updated on 05-01-20

What is the long-term outlook for people with familial hemiplegic migraine?

Although most people with familial hemiplegic migraine (FHM) recover completely between episodes, neurological symptoms such as memory loss and problems with attention can last for weeks or months. The occurrence of FHM attacks tends to decrease with age. The eventual neurologic outcome is often benign; however, about 20 percent of individuals with FHM develop mild but permanent difficulty coordinating movements (ataxia), which may worsen with time, and nystagmus (rapid, involuntary eye movements). Unusually severe migraine episodes have been reported in some people with FHM. These episodes may include fever, seizures, prolonged weakness, coma, and, rarely, death.

Last updated on 05-01-20

How might familial hemiplegic migraine (FHM) be treated?

There are no official treatment guidelines for familial hemiplegic migraine (FHM), and no randomized, controlled trials regarding treatment for hemiplegic migraine have been conducted. People with hemiplegic migraine typically are treated with the same medicines used for typical migraine with aura (for pain, and to stop or prevent migraines). However, medicines that constrict the blood vessels (vasoconstrictors) should be avoided because they may increase the risk for stroke. Examples of vasoconstrictors that may be used to treat typical migraine with aura include triptans and ergotamines. Treatment may depend on the severity and frequency of attacks as well as specific symptoms, and therefore may vary from person to person. Multiple therapies, either alone or in combination, may need to be tried before finding a treatment regime that is helpful.

Treatment of sudden hemiplegic migraine “attacks” aims to ease symptoms and may include the use of non-steroidal anti-inflammatory drugs (NSAIDs), anti- nausea medicines (antiemetics), and/or prescription pain medicines. A medicine called ketamine, ingested through the nose (intranasal), may shorten the duration of aura symptoms if taken as soon as symptoms begin.

Examples of medicines that may be used to prevent attacks (prophylactic medicines) may include verapamil, flunarizine, ketamine, lamotrigine, and naloxone. Non-randomized studies have suggested acetazolamide may be effective in preventing attacks in some people with FHM. Other medicines that may be used to prevent attacks include amitriptyline, topiramate, and valproic acid. Individualized anti-seizure therapy may additionally be needed for people with FHM who have seizures (particularly those with FHM type 2).

Last updated on 05-01-20

Where To Start

The Migraine Trust

The Migraine Trust, a support organization, offers information on Familial hemiplegic migraine

Last updated on 04-27-20

Name: The Migraine Trust 4th Floor Mitre House
44-46 Fleet Street
London, EC4Y 1BN, United Kingdom
Phone: 0203 9510 150 Email: https://www.migrainetrust.org/about-us/contact-us/contact-us/ Url: https://www.migrainetrust.org/
Name: American Migraine Foundation AMF 19 Mantua Rd.
Mount Royal, NJ, 08061, United States
Phone: 856-423-0043 Fax : 856-423-0082 Email: amf@talley.com Url: https://americanmigrainefoundation.org/

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