Non-Familial Hemiplegic Migraine Responsive to Naloxone

Abstract

Two cases of non-familial hemiplegic migraine are described. Naloxone reversed the neurological deficits accompanying attacks, whereas the pain was uninfluenced. The possibility that the opiate-antagonist naloxone facilitates regression of neurological symptoms associated with migraine attacks in general is voiced.

Sporadic hemiplegic migraine

“…Two patients, one with possible SHM and the other with what was termed complicated migraine without apparent weakness, were administered 0.4 mg of intravenous naloxone, which aborted neurologic sequelae but not the pain associated with multiple attacks within 2 minutes. The authors postulated a role for endorphins in the pathophysiology of migraine, but no other published trials of naloxone have occurred to substantiate this effect [43].…”

Evidence for a separate type of migraine with aura

“…1 However, patients with similar clinical symptoms but without other affected family members have been reported, [2][3][4][5][6][7][8][9][10][11][12][13] and the term sporadic hemiplegic migraine (SHM) has been used. 2,7,9,11,12 Currently, these patients are classified as having migraine with typical aura (MA) or migraine with prolonged aura according to the classification of the International Headache Society (IHS classification).…”

Sporadic hemiplegic migraine: report of a case with clinical and radiological features

“…Treatment strategy at present is only on the basis of case reports of effective treatment with Flunarizine, Naloxane and Verapamil [8–10]. At present, SHM is treated on the same lines as familial hemiplegic migraine.…”