Migraine and stroke are distinct medical conditions that can present with overlapping symptoms, leading to diagnostic challenges. While a migraine involves neurological dysfunction, a stroke results from an interruption of blood supply to the brain, causing damage to brain cells. This article clarifies how certain migraine types can mimic stroke symptoms and provides guidance on distinguishing between these two conditions.
Shared Symptoms That Cause Confusion
Migraines, especially those accompanied by aura, and strokes can share several neurological symptoms, making self-diagnosis difficult. Visual disturbances are common to both, including flashing lights, zig-zag patterns, blind spots, or temporary vision loss. Individuals might also experience sudden confusion or disorientation.
Other symptoms include numbness or weakness on one side of the body, affecting the face, arm, or leg. Speech difficulties, such as slurred speech or trouble finding words, also occur. While migraines are typically associated with pain and most strokes are not, a sudden, severe headache can be a symptom in both, particularly in certain types of stroke like a subarachnoid hemorrhage.
Key Distinctions Between Migraine and Stroke
Despite similarities, several key differences help distinguish between a migraine and a stroke. The onset speed of symptoms is a primary differentiator. Stroke symptoms usually appear very suddenly, reaching peak intensity within minutes, whereas migraine aura symptoms tend to develop more gradually over 5 to 20 minutes.
Symptom progression also varies; stroke symptoms are generally fixed and may worsen, indicating ongoing damage. In contrast, migraine aura symptoms often evolve, spread, and typically resolve within an hour. Migraines frequently involve associated symptoms like light sensitivity (photophobia), sound sensitivity (phonophobia), nausea, and vomiting, which are less common or absent in a stroke.
Migraine headaches are commonly described as throbbing, unilateral, and worsened by physical activity. While a stroke can cause a sudden and severe headache, it is not always the primary symptom, and its characteristics can differ from a typical migraine. Stroke symptoms are persistent and can indicate permanent brain damage, while migraine aura symptoms are temporary and typically resolve without lasting effects on the brain.
Specific Migraine Types That Mimic Stroke
Certain migraine types are known for mimicking stroke symptoms due to their severe neurological manifestations. Hemiplegic migraine is a rare form characterized by temporary weakness or paralysis on one side of the body. This muscle weakness usually begins during the aura phase and can be accompanied by sensory changes, vision problems, or speech difficulties.
Hemiplegic migraine can be either familial or sporadic, occurring without a known family history. Migraine with aura, especially when complex or prolonged, can cause concern. Visual disturbances, such as flashing lights or zig-zags, are common with aura. Unusually long or severe aura symptoms, such as sensory changes lasting for hours, can cause confusion.
When to Seek Emergency Medical Care
Any sudden onset of neurological symptoms that could indicate a stroke should be treated as a medical emergency. Acting quickly is paramount, as “time is brain” for stroke treatment. Call emergency services immediately if symptoms appear suddenly and severely, or if they are new or unusual.
The F.A.S.T. acronym serves as a helpful reminder of key stroke signs: Face drooping on one side, Arm weakness (one arm drifting downward when raised), Speech difficulty (slurred or garbled speech), and Time to call emergency services immediately.
Transient ischemic attacks (TIAs), or “mini-strokes,” can present with symptoms similar to migraine aura, such as speech impairment, muscle weakness, and visual disturbances. Even if symptoms resolve, seeking prompt medical evaluation is advised to rule out a TIA or other serious conditions.