How do you treat patients with hemiplegic migraine?

The is no agreed-upon treatment for hemiplegic migraine. I have often used NSAID’s acutely, occasionally triptans, and rarely steroids when nothing is working. The relatively new acute care gepants could be tried, but I have not done that as these patients are hard to find.

I would consider adding a...

I would treat a patient with hemiplegic migraine no different from any other migraine patient with a triptan or gepant abortively and, if needed, a gepant or CGRP antibody preventively.