1.2.3.1.3 Familial hemiplegic migraine type 3 (FHM3)

A man describes his second recorded attack. He describes it beginning with an odd jerking, restless quality in his right hand, almost like it wanted to move on its own, before proper weakness set in over the same hand and forearm, to the point he could not hold his phone steady. Around the same time his speech became halting and thick, with noticeable word-finding trouble. Talking through the timeline, the jerking, then the weakness, then the speech change, unfolded across a good half hour, nearer thirty-five minutes by his estimate, rather than appearing together. His mother has a well-documented history of nearly identical spells with the same right-sided weakness, and her case was thoroughly assessed years ago and found to meet every element of the inherited pattern recognised in specialist clinics. He denies loss of consciousness and remains neurologically intact between attacks, both on his own account and on examination. Genetic testing has confirmed the same disease-causing SCN1A variant in his own blood, matching the finding that confirmed the same disease-causing SCN1A variant in his own blood.