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Light Sensitivity and Visual Aura of Hemiplegic Migraine

Light Sensitivity and Visual Aura of Hemiplegic Migraine

Written by Greg Bullock on 7th Apr 2019

Hemiplegic migraine is a rare subtype of headache disorder that features temporary weakness, numbness and even non-permanent paralysis—usually on one side of the body. In effect, it has the hallmark characteristics of a stroke but in the package of a migraine attack. This also means that it can yield migraine symptoms too, such as light sensitivity and visual aura, which we explore in depth in this post.

Hemiplegic Migraine, Visual Aura and Light Sensitivity

Hemiplegic migraine is actually defined as a type of migraine with aura, with stroke-like complications appearing in the moments before the attack and often continuing during the episode. However, visual aura can often accompany these motor deficits too, with roughly 90% of hemiplegic migraine patients (both familial and sporadic) reporting visual disturbances.1,2 This includes symptoms such as:

  • Flickering or flashing lights
  • Scintillating scotoma or zig-zag patterns
  • Partial loss of vision

Astoundingly, the visual aura associated with hemiplegic migraine has been shown to last an average of 90 minutes before the acute or attack phase begins.2

Although these visual complaints might seem like a form of light sensitivity (or photophobia as it is called), they actually are separate issues. There is a lack of evidence regarding the onset of light-sensitive pain in the pre-attack phase, but people with hemiplegic migraine do have a greater number of total prodromal symptoms.3 And like other migraine types, it is not unreasonable to think that heightened intolerance to light during this period is one of the many issues they face.

Light Sensitivity, Photophobia During Hemiplegic Attacks

Although not part of the diagnostic process, research overwhelmingly supports that photophobia and sensitivity to light affect hemiplegic migraine sufferers at the same rate as other migraine disorders. Some experts have even claimed that the presence of photophobia and phonophobia (sound sensitivity) during an attack is a greater risk factor for hemiplegic migraine than any other migraine variant.4

Just how prevalent is light sensitivity as a symptom of hemiplegic migraine? More than 85% of patients with either the familial or sporadic HM type have this strong aversion to bright light.1,2 In fact, outside of the aura symptoms, it is the most prominent physiological experience; even an actual headache or head pain is less common!

The descriptions of hemiplegic-related light sensitivity are powerful too. Here is how Jocelyn Leo described it in an article for The Mighty:


"Hemiplegic migraine means shutting all the blinds in my house because the sun hurts too badly. Hemiplegic migraine is having to push myself through my homework because I can feel my fingers starting to go numb and I don’t know how much longer I will be able to write for. Hemiplegic migraine is not being able to walk as far or as long as I used to be able to because the right side of my body is weakened from so many attacks."


Unfortunately, this attack phase can (and regularly does) last for several hours for patients. In rare cases, it can even persist over the course of multiple days.5,6 This ultimately means the motor deficiencies, headache pain (if present) and light sensitivity symptoms continue without relief or respite. It is also likely that those with hemiplegic migraine—like most other types of migraine—have to endure lower light tolerance after the symptomatic period has passed. This might not only make them more sensitive between attacks but make their brain more susceptible to being negatively activated by light.

Light as a Trigger for Hemiplegic Attacks

Living with migraine is often about finding a balance between medication and other treatments to manage not just the symptoms but the triggers that bring them on. Part of being light sensitive as a person with migraine means also having a lower threshold for any light exposure. This creates a risk for developing the visual and motor aura, headache pain and other migraine symptoms simply because you were face-to-face with bright light.

Triggering factors vary between patients and may not even be consistent between attacks, but light definitely plays a role for many with hemiplegic migraine. In fact, light was a negative influence for more than half of people with familial hemiplegic migraine who had identified at least one trigger. And a significant percentage of those believed that it almost always led to an attack.7 Specific light-related related triggers typically include:

Only stress was deemed to be a more likely catalyst for hemiplegic episodes. Interestingly, one study also showed that light was more problematic for persons with hemiplegic migraine versus migraine with or without aura.7 (Related: See the latest ranking for migraine with aura triggers here)

Can TheraSpecs Help Hemiplegic Migraine Light Sensitivity?

TheraSpecs glasses use a specialty coating or tint to block wavelengths of light that can lead to migraine attacks—including ones of hemiplegic origin. We recently shared stories from a few customers with this rare migraine subtype who used our glasses to find relief. Read about their experiences with TheraSpecs:

"This is Truly a Wonderful Gift" (Robert’s Story) ➜

"You Saved My Whole Career" (Kimberly’s Story) ➜

"I'm in Charge of My Health Now" (Erica’s Story) ➜

We also encourage you to learn more about how TheraSpecs can improve your light sensitivity and hemiplegic migraine symptoms by clicking on the button below.

References:

1Thomsen LL, Ostergaard E, Olesen J, Russell MB. Evidence for a separate type of migraine with aura: sporadic hemiplegic migraine. Neurology. 2003 Feb 25;60(4):595-601.

2Thomsen LL, Eriksen MK, Roemer SF, Andersen I, Olesen J, Russell MB. A population-based study of familial hemiplegic migraine suggests revised diagnostic criteria. Brain. 2002 Jun;125(Pt 6):1379-91.

3Cuvellier JC. Pediatric vs. Adult Prodrome and Postdrome: A Window on Migraine Pathophysiology?. Front Neurol. 2019;10:199. Published 2019 Mar 8. doi:10.3389/fneur.2019.00199.

4Pamatmat R., et al. Clinical profile of migraine and hemiplegic migraine in a tertiary hospital. Journal of the Neurological Sciences, Volume 381, 942.

5Bhatia R, Desai S, Tripathi M, et al. Sporadic hemiplegic migraine: report of a case with clinical and radiological features. J Headache Pain. 2008;9(6):385–388. doi:10.1007/s10194-008-0067-1.

6Schwedt TJ, Zhou J, Dodick DW. Sporadic hemiplegic migraine with permanent neurological deficits. Headache. 2013;54(1):163–166. doi:10.1111/head.12232.

7Hansen JM, Hauge AW, Ashina M, Olesen J. Trigger factors for familial hemiplegic migraine. Cephalalgia. 2011 Sep;31(12):1274-81. doi: 10.1177/0333102411415878. Epub 2011 Jul 22.

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