1.2.3.2 Sporadic hemiplegic migraine (SHM)

A 45-year-old hairdresser reports three such episodes to date, most recently last month. Each begins with a peculiar warning sensation that she struggles to put into words, followed almost immediately by bright, sparkling zigzags appearing in the corner of her vision. At the same time she notices pins-and-needles creeping up her fingers on one hand. Within what she estimates as about a quarter of an hour, the same hand becomes distinctly weak and clumsy, making it hard for her to hold objects steady. A throbbing headache then follows, arriving before fifty minutes have passed since the visual symptoms started. Her maternal grandmother apparently had comparable warning spells before her own headaches, but this was never formally assessed as meeting the specific weakness threshold under discussion here.