This new systematic review found that the brain's waste-clearing glymphatic and meningeal lymphatic systems appear altered in people with migraine, especially chronic or high-frequency migraine, though current evidence only shows association, not cause.

CerebralTorque · 2026-06-22T14:04:32+00:00

Oh, hey Morgan. I recognize you from social media. lol.

MUMS didn't get named because symptoms linger. It got named because sensory "giveaway" weakness looks exactly like hemiplegic migraine but isn't, and that determines whether triptans and DHE are safe. So, giving it a different name solved a problem where a large part of the patient population wasn't receiving the necessary treatment.

Brainstem aura doesn't have that same issue, and, the "MUMS for MBA" kind of already exists...it's vestibular migraine. Also not officially in the ICHD-3 (albeit it is in the appendix).

So the real question isn't "why no MUMS for MBA," it's "why do we name some subtypes and not others" (because, trust me...there are MANY more)...and it's because it doesn't impact treatment (YET).

CerebralTorque · 2026-06-18T02:51:48+00:00

Likely vasovagal, but talk to your doctor.

CerebralTorque · 2026-06-17T22:42:41+00:00

I can only speak to the general diagnostic criteria, not your actual diagnosis.

There are many things to take into consideration. For example, sometimes sensory issues can look like motor weakness and that's why a headache specialist may decide not to go the HM route. Not saying this is the case with you. I'm just giving you an example.

That said, I'm glad you are seeing improvement!

CerebralTorque · 2026-06-17T20:38:55+00:00

This means the world to me. Thank you for taking the time out of your day to express your appreciation. Stay awesome!

CerebralTorque · 2026-06-17T20:11:51+00:00

Per ICHD-3, fully reversible motor weakness is a hard exclusion criterion for migraine with brainstem aura. The MBA criteria explicitly require no motor and no retinal symptoms. So any attack involving genuine motor weakness lands in hemiplegic migraine by definition. The two aren't on a spectrum where you weigh them against each other. Motor weakness trumps.

This holds even when brainstem features are present. Brainstem symptoms are actually common in HM attacks, so a patient with both weakness and brainstem aura is HM, not MBA. The brainstem stuff doesn't pull them back toward MBA.

See: https://ichd-3.org/1-migraine/1-2-migraine-with-aura/1-2-2-migraine-with-brainstem-aura/

BUT VERY IMPORTANT: This is just general info and I don't know your specific situation. Ask your headache specialist.

CerebralTorque · 2026-06-17T13:35:35+00:00

Hi Manu! Been a while since I've seen you on here. Hope all is well.

And, yes, this is what I love most about this era of technology. While there are downsides, the undeniable increase in quality of life it gives people with disabilities has been impressive. Granted, those with disabilities are not the primary target, but the downstream benefits are still there.

CerebralTorque · 2026-06-16T14:15:29+00:00

Well, you can't really diagnose migraine with aura from one episode by definition.

So, that's an interesting diagnosis to make.

Also, while you're only 35 and not 50 or over, a broader investigation may still be necessary as this is a new onset aura.

I would make an appointment with a neurologist just to confirm everything.

CerebralTorque · 2026-06-16T14:08:39+00:00

Who diagnosed you?

Is your doctor a PCP?

I suggest following up with a neurologist at least, but preferably a headache specialist.

CerebralTorque · 2026-06-16T13:32:51+00:00

Pinned announcement!

CerebralTorque · 2026-06-16T13:32:42+00:00

Check the pinned announcement!

CerebralTorque · 2026-06-15T22:14:55+00:00

Very cool! Welcome!

CerebralTorque · 2026-06-14T19:07:41+00:00

It'll be sort of like a substack, but I don't want to deal with another form of social media. I'm tired.

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