MUMS – Migraine and Arm Weakness

Migraine researchers are struggling with a type of migraine that is just starting to be understood, known as MUMS – that is, migraine with unilateral motor symptoms. One of the most unusual symptoms is a type of weakness in one arm.

MUMS has been connected in the past with hemiplegic migraine. That’s because the key symptom with hemiplegic migraine is a kind of temporary paralysis on one side of the body.

But there seems to be a group of migraine patients who fit or almost fit the description of hemiplegic migraine, and yet they have somewhat unique symptoms.

So what is the key symptom of MUMS? Every patients with MUMS has a kind of weakness or paralysis in one arm and/or hand. Commonly it’s a kind of weakness called “give-way” “give-away” “collapsing” weakness.

Give-way weakness is diagnosed when pushing on the arm is resisted, but the arm “gives-way” suddenly for no apparent reason.

Patients with MUMS also often suffer from dizziness, numbness, allodynia (painful/sensitive areas of the skin), visual aura and other visual problems, language problems, confusion, and pins and needles.

What makes things even more scary is that the arm weakness may continue even when patients are not in the middle of an actual migraine attack.

Some patients have been confused by the discussion around “give-way weakness” and “true weakness”. Some doctors seem to suggest that the weakness is somehow “imaginary”.

The fact is that, as with many migraine symptoms, no one is sure what is causing the weakness. It may be that it’s another symptom coming from activity in the brain, the same activity that seems to cause visual auras. It’s not voluntary or imaginary at all.

Because of some of the related symptoms, such as allodynia, the give-way weakness could also be a “protective” measure, to try to avoid the pain and discomfort of other symptoms (which can be quite severe and disabling in MUMS).

Whatever the case, experts are recognizing that MUMS is certainly a real and serious problem.

MUMS tends to show up later in life than hemiplegic migraine, usually in the patient’s 30s, as opposed to the 20s.

Many patients with MUMS, as with hemiplegic migraine, are initially told they’ve had a stroke. And MRI should clarify whether or not the symptoms are from stroke.

It’s very important to diagnose MUMS, because there are certain treatments that may be more successful with MUMS than with other types of migraine. For example, as with hemiplegic migraine, verapamil may help.

Of course any first-time symptoms like this should get you to emergency right away. Stroke should be diagnosed as soon as possible. If you do find out you have a type of migraine, early treatment is also very important.

Resources and sources:

• Migraine with unilateral motor symptoms: a case–control study
• Migraine (Contemporary Neurology Series) 3rd Edition
• A Dictionary of Neurological Signs
• Acute Headache
• Treatment of prolonged migrainous aura in familial hemiplegic migraine (FHM) and in migraine with unilateral motor symptoms (MUMS) with intravenous verapamil