Hemiplegic migraine is a rare form of migraine characterized by temporary muscle weakness on one side of the body, which can be accompanied by visual, sensory, or speech changes. While the exact causes of hemiplegic migraine are complex and often involve genetic factors, certain dietary elements are frequently identified as potential triggers for an attack.
Understanding Hemiplegic Migraine and Food Triggers
This weakness often appears during the “aura” phase, which can also involve visual disturbances like blind spots or flashing lights, numbness, tingling, or difficulty speaking. These symptoms can be alarming and may resemble a stroke.
Food does not cause hemiplegic migraine itself, but in susceptible individuals, specific foods or dietary patterns can act as “triggers” that initiate an attack. The body’s response to these triggers is highly individualized, meaning what affects one person may not affect another. Identifying these personal triggers is a key part of managing hemiplegic migraine, as avoiding them can help reduce the frequency or severity of episodes.
Common Dietary Culprits
Several food categories and specific items are frequently reported as potential triggers for migraine attacks. Aged cheeses, such as cheddar, blue cheese, Parmesan, and feta, are often implicated. Cured and processed meats like bacon, hot dogs, salami, and deli meats are also common suspects.
Chocolate is another food frequently mentioned, although research on its role as a migraine trigger is mixed. Caffeine can be a complex trigger; both excessive intake and withdrawal from caffeine can initiate a migraine. Artificial sweeteners, particularly aspartame and sucralose, found in diet sodas and sugar-free products, are also noted as potential triggers.
Fermented foods like sauerkraut, kimchi, and soy sauce, along with certain nuts and citrus fruits, are also sometimes reported. Some people may find that specific food combinations, rather than single foods, are more likely to trigger an attack.
Key Dietary Compounds and Their Role
The reason certain foods may trigger migraines lies in specific chemical compounds they contain. Tyramine, an amino acid, is found in aged and fermented foods. In individuals with insufficient levels of the enzyme monoamine oxidase (MAO), which breaks down tyramine, higher levels of tyramine can accumulate and potentially affect brain signaling chemicals, leading to a migraine.
Nitrates and nitrites, commonly used as preservatives in processed meats, are another group of implicated compounds. These substances can cause blood vessels to dilate, which some theories suggest may contribute to migraine attacks. Sulfites, used as preservatives in wine, dried fruits, and other processed foods, are also considered potential triggers for some individuals, possibly by affecting blood vessels or triggering an immune response.
Monosodium glutamate (MSG), a flavor enhancer present in many processed foods, has been debated as a migraine trigger. While research is mixed, some theories suggest MSG’s role in brain signaling, specifically its excitatory effect on neurons, could contribute to attacks in sensitive people. Artificial sweeteners like aspartame and sucralose are thought to potentially interfere with neurotransmitter levels, such as serotonin, or increase brain excitability, which might initiate a migraine.
Strategies for Identifying Personal Triggers
Keeping a comprehensive food and symptom diary is the primary method for tracking potential triggers. This involves meticulously recording all foods and beverages consumed, alongside the timing, severity, and associated symptoms of any migraine attacks. Over time, patterns may emerge, highlighting specific foods or compounds that consistently precede an attack.
An elimination diet can also be a useful tool, though it should ideally be undertaken under professional guidance. This process involves removing suspected trigger foods from the diet for a period, typically several weeks or months, and then reintroducing them one by one to observe any reactions. This method requires careful planning to ensure nutritional adequacy and accurate identification of triggers. Before making significant dietary changes, it is highly advisable to consult with a healthcare professional, such as a neurologist or a registered dietitian specializing in migraines. They can provide personalized advice, ensure the dietary approach is safe and appropriate, and help interpret findings from food diaries or elimination diets.