1.2.4 Familial hemiplegic migraine (FHM)

Case report

"I have been trying to figure out what areas are involved in my migraines. They have often had a very obvious right visual field upper/mid quadrant visual aura, so I have assumed that the origin is left temporal lobe. I usually get numbness of the left side of my face, and weakness on the left side of my tounge. On a few severe occassions I had hemiparesis and was unresponsive to reflex testing on my left arm and leg. I'm a neuroscientist and am frustrated that I don't know what is going on in my brain. What I find strangest is that I will often have an aphasia in which I can form words in my brain, can write or use sign language fluently, but cannot speak without EXTREME effort, and then only haltingly [i.e. dysphasic speech disturbance in familiar hemiplegic migraine]. This doesn't seem to match the Broca's or Wernicke's aphasias; is it possible that the language area itself isn't affected, but only its connection to verbal motor regions??? On a personal note, it has caused bad feelings when I don't respond to people, but my family now knows that if I stand there bobbing my head with my mouth shut, something is probably going on. - In fact, my migraines are probably familial hemiplegic, as my mom has very similar symptoms, including confusion, facial numbness and left side hemiplegia. She does not, however, appear to have speech or language disturbances."

(Amber Buhler, Email to Klaus Podoll, July 26, 2005)