12/10/07 #3 - Criteria to be a candidate for genetic testing for FHM Hemiplegic Migraine?

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  • Full Question:
    I would like to know what criteria a patient needs to meet in order to be a candidate for genetic testing for FHM Hemiplegic Migraine disease?

    I suffer from acute auras with my migraine attacks and have motor weakness on the left side. All of my symptoms are on my left side, however, at the end of the migraine I tend to have some symptoms that will be on both sides, like inadvertent reflexes of my foot on the right side (like knee jerk responses) and twitching of the bottom of my right eye. It ends with aphasia that lasts around 4-6 days.

    I am under the care of a neurologist. I have a family history of migraines. Most of what I know about is my maternal grandmother. She had migraine attacks that are severe and acute like mine. She went to the emergency room on several occasions. My mother suffers from migraine disease too, but not as severe, though almost as debilitating. My grandmother and I both began with migraines in childhood, whereas my mother began having them in her early 40s.

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    I don't expect a diagnosis from you, but is it plausible for me to ask for a genetic test with what I have told you? Every neurologist that has seen me since childhood has acted as if they are completely befuddled with me. If a calcium blocker would benefit me, I want to know! If I don't need to take triptans, I want to know! What do you think? Brigitte.

     

     

     

    Answer:

     

    Dear Brigitte;

     

    Your question and description of your headache are very detailed and is certainly possible that this FHM could have been present in your family and you. Unfortunately, there is no common testing genetically and, as far as I know, most of the tests are done by very specialized research labs. There is a very recent publication from the Netherlands, from Dr. Ferrari’s group, showing that about 20% of suspected FHM patients actually turned out to have genetic defects. That means that 80% of suspected FHM patients do NOT have the suspected disease. You can read more about that publication in Hemiplegic Migraine - Genetic Testing May Be Helpful. Keep in mind that neurologists aren't necessarily Migraine specialists and consider seeking care from an actual specialists. There's a link below to our directory of specialists if you need it.

     

    Good luck,
    John Claude Krusz and Teri Robert

     

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    About Ask the Clinician:

    Dr. Krusz is a recognized expert in the fields of headache and Migraine treatment and pain treatment. Each week, he and Lead Expert Teri Robert, team up to answer your questions about headaches and Migraines. You can read more about Dr. Krusz or more about Teri Robert.

     

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    We hope you find this general medical and health information useful, but this Q & A is meant to support not replace the professional medical advice you receive from your doctor. For all personal medical and health matters, including decisions about diagnoses, medications and other treatment options, you should always consult your doctor. See full Disclaimer.

     

    © Teri Robert and J.C. Krusz, 2007.

    Last updated December 10, 2007.

Published On: December 10, 2007