What have been your experiences with anti-CGRP therapies for hemiplegic migraine?  

I think it is important to point out that true hemiplegic migraine is very rare. Many patients are incorrectly diagnosed with (sporadic) hemiplegic migraine, and actually have sensory aura or *MUMS. These patients can absolutely have CGRP-targeted medications.In terms of true hemiplegic migraine, I ...

In a small sample size, I have not noticed a difference in response to CGRP-blocking medications in patients with hemiplegic migraine vs migraine with other aura or migraine without aura. I have not seen a change in aura symptoms (worsening in aura symptoms) after starting CGRP blocking medications....

It is a great question because it highlights some of the most important "unknowns" when considering anti-CGRP therapies. I will begin with two anecdotes and then follow with the theoretical concerns. When the first CGRP receptor antibody came out, like most headache specialists, I turned to it for m...