By Wanda –
We were coming home from vacation, driving across Virginia, the first time it happened. I thought perhaps it was just the remnants of the last migraine combined with the drive through the mountains. When it became a struggle to keep driving – literally to go in a straight line – we stopped for the night. They asked at the front desk if I was okay, and my daughter responded, “she has a migraine.”
Ruth was right, but the reality of the situation was much scarier. Come morning we were back on the road, headed to a neurologist appointment for Ruth who was being checked out for a non-migraine problem.
See, I’m the only one in my family with migraines. No sooner had Ruth checked herself in, when I was swarmed with nurses, the PA, and finally the doctor. They were convinced I had had a stroke, and they weren’t far off. What I was experiencing is called a Sporadic Hemiplegic Migraine. Just when you think migraines can’t get worse, they do.
What is Sporadic Hemiplegic Migraine (SHM)?
Sporadic Hemiplegic Migraines (SHM) can occur with and without visual auras common in other types of migraine, or with auras characterized by temporary numbness or weakness, often affecting one side of the body. Additional features of SHM auras include difficulty with speech, confusion, drowsiness, and loss of balance.
Some people with SHM experience unusually severe migraine episodes (mine have been known to last three days). These episodes can include the SHM aura symptoms as well as fever, prolonged weakness, and in some cases, seizures or comas—however, I don’t experience this.
Most people with SHM recover completely between episodes, but there are those who, like me, have them more often than most who also have neurological symptoms such as memory loss and problems with attention that can last for weeks or months. These problems can, and in my case, do, worsen with each SHM episode.
My Battle with SHM
Enough dry facts, let’s get back to the story.
Since strokes run in my family, I got to spend six lovely days in the Stroke Unit at Carilion’s Roanoke Memorial Hospital. It’s not a vacation spot worth recommending.
The first three days were spent stabilizing me and determining I had NOT had a stroke. The next two were weekend days, so not much happened aside from lots of blood work, a chemical stress test, and a couple visits from nurses on the “other side” of the neuro ward where my DHE treatments (dihydroergotamine: an ergot medication for migraine) were done. They brought treats!
That Monday, I met with my neurologist and the head of the department. They told me about SHMs, explained that an MRI was needed to be sure there was no brain damage (Ruth said they’d be lucky to find a brain), and that I was being sent home to rest. Yeah, right. Single mom, teenager, just back from vacation, and they expected rest?!
The MRI was done the following week, and showed Dawson’s Lesions (they look like God’s finger painting on my brain) which could have been caused by the SHM, or could cause the SHM. No one knows for sure.
Aside from rest, there is no treatment for SHM, nor is there a preventative. Life goes on… I refuse to let SHM get in the way of life. My diet has changed, especially since Daddy survived his hemiplegic stroke, and we monitor my speech and motor skills after each SHM.
There are schools of thought that link migraines with a higher probability of stroke, and tell us SHM increases our risks even more, just as having strokes run in the family does. I’m only 48, and Daddy is 80 and still works full time POST-stroke. I have a ways to go before allowing SHMs to slow me down!