1.2.3.1.1 Familial hemiplegic migraine type 1 (FHM1)

A 20-year-old undergraduate reports neurological spells, at least two such spells in her life so far. Each one unfolds gradually over several minutes, taking more than five minutes to fully develop: she first notices an odd clumsiness in one hand, struggling to hold her pen, then her speech becomes thick and difficult to form, and finally a definite weakness sets into the same hand, with each feature clearly following the one before rather than starting together. The whole spell, from the first clumsiness to the weakness settling, takes roughly thirty minutes. She has not noticed a significant headache with these spells, and there is no confusion afterwards. Her cousin experienced very similar spells and underwent thorough specialist assessment, which confirmed the same diagnostic pattern applied to her as well, and a CACNA1A gene mutation has been confirmed in the patient too.