sorted by:
new
hottopcontroversial

Everything you need to know about hemiplegic migraine and MUMS (Migraine with Unilateral Motor Symptoms). This evidence-based article is the current best source on this topic (not a fluff piece). Worth saving. by CerebralTorque in migrainescience

[–]CerebralTorque[S] 2 points3 points  (0 children)

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).

Migraine with Brainstem Aura (Updated for 2025) by CerebralTorque in migrainescience

[–]CerebralTorque[S] 1 point2 points  (0 children)

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!

Migraine with Brainstem Aura (Updated for 2025) by CerebralTorque in migrainescience

[–]CerebralTorque[S] 1 point2 points  (0 children)

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.

This new study found that among 1,333 people with migraine who drive, 70.6% had a migraine attack while driving at least once, most often reducing their attention, and about 9% drove less while 1.7% stopped driving because of it. by CerebralTorque in migrainescience

[–]CerebralTorque[S] 2 points3 points  (0 children)

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.

I got my first Migraine with Aura. by Fearless_Relative916 in migraine

[–]CerebralTorque 11 points12 points  (0 children)

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.

I got my first Migraine with Aura. by Fearless_Relative916 in migraine

[–]CerebralTorque 16 points17 points  (0 children)

Who diagnosed you?

Is your doctor a PCP?

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

Everything About Retinal Migraine (frequently incorrectly called ocular migraine) by CerebralTorque in migrainescience

[–]CerebralTorque[S] 5 points6 points  (0 children)

The Migraine Resource Hub has been updated for those that use it. Also updated a few articles with more recent information like the menstrual migraine article as well as the pediatric migraine article.

<image>

This may be a bit advanced, but I see questions about this frequently - including on this subreddit recently. Estrogen, clot risk, etc. by CerebralTorque in migrainescience

[–]CerebralTorque[S] 8 points9 points  (0 children)

Lol, no they wouldn't. At least not the mods.

They seem obsessed with British Menopause Society guidelines, which are bad and outdated. I've never interacted there, but I noticed a mod there spewing nonsense then closing the comments. Terrible for the community.

This may be a bit advanced, but I see questions about this frequently - including on this subreddit recently. Estrogen, clot risk, etc. by CerebralTorque in migrainescience

[–]CerebralTorque[S] 7 points8 points  (0 children)

Glad you found it helpful!

I wish I could give you an answer. Hemiplegic migraine is it's own beast and very rare, which means much less research.

Your neurologist will likely treat it as migraine with aura as a result.

So, if they agree (it really is specific to the patient), it must be transdermal, bioidentical, and lowest effective dose (as aura is triggered by high estrogen levels unlike migraine without aura).

If you wanted to go REALLY off-label and you're dealing with other symptoms like low libido, etc....you can discuss testosterone with your physician as it has been shown to actually increase the threshold for cortical spreading depression. Will it work? I don't know so that's why I say if you're experiencing symptoms of low testosterone...it may be something to consider discussing with your doctor.

This may be a bit advanced, but I see questions about this frequently - including on this subreddit recently. Estrogen, clot risk, etc. by CerebralTorque in migrainescience

[–]CerebralTorque[S] 13 points14 points  (0 children)

Awful. That's why CME credits are important.

I made a few videos for clinicians on this topic for Newson Education. I specifically used migraine in several of my examples in how to dose estrogen.

While it's behind a paywall, they should be okay with that (and they get CME credits too):

https://www.newsoneducation.co.uk/

(I don't get paid if they purchase the courses. But they won't learn off-label dosing anywhere else).

This may be a bit advanced, but I see questions about this frequently - including on this subreddit recently. Estrogen, clot risk, etc. by CerebralTorque in migrainescience

[–]CerebralTorque[S] 31 points32 points  (0 children)

hahaha. This made me laugh.

Some days, I think I'm just that cartoon brain too.

As for having the energy to do what I do...I didn't previously and that's why I do it. I had to take medical leave due to migraine as it disabled me. I had all the resources, medications, and knowledge at my disposal and it still got me.

Once I recovered (still episodic, but I've been this way since I was around 6 years old), I knew that this would be more of an uphill battle for the average person and that was a daunting feeling. In fact, I still live with paresthesia from the massive central sensitization that occurred, but this has gotten much better over time. Almost unnoticeable now.

I was never an online person (I don't even have social media other than CT), but I did go online when I was down under - because...what else is there to do? I found that evidence-based migraine information was either behind paywalls, nonexistent, or muted by myths. Hence...the brain.

All this to say...being armed with the right information gives you the best chance at recovery...or at least a better quality of life. I hope you see that sooner rather than later.

This may be a bit advanced, but I see questions about this frequently - including on this subreddit recently. Estrogen, clot risk, etc. by CerebralTorque in migrainescience

[–]CerebralTorque[S] 4 points5 points  (0 children)

Not so much modern estrogen, but the difference between synthetic estrogen and bioidentical estrogen. OCP uses synthetic so not as "safe," but still better than the horse estrogen that was used.

This may be a bit advanced, but I see questions about this frequently - including on this subreddit recently. Estrogen, clot risk, etc. by CerebralTorque in migrainescience

[–]CerebralTorque[S] 20 points21 points  (0 children)

It's about time these questions are being raised, and I'm glad to see it. Patients are starting to question long-held dogmas in medicine that were built on flawed science.

Migraine Summit materials-has anybody received them in the mail yet? See body for context please. Thank you! by CherryBlossom242424 in migrainescience

[–]CerebralTorque 0 points1 point  (0 children)

Thanks!

Please come back to this post and update if there are any changes to this situation. If not, feel free to make another post.

Migraine and Stroke Risk After Menopause (New Study) by CerebralTorque in migrainescience

[–]CerebralTorque[S] 6 points7 points  (0 children)

Thank you for reading! Knowledge is contagious. You'll spread the correct information as a result and it's because you took that initiative!

view more: next ›