Does neuronal calcium channel dysfunction underlie hemiplegic migraine, and is calcium channel blocker therapy effective?
The authors describe 4 patients with sporadic hemiplegic migraine (SHM) who were responsive only to oral or intravenous verapamil – not to other common migraine therapies. The authors had previously reported a successful response to intravenous verapamil in familial hemiplegic migraine (FHM); this study confirms the efficacy of this agent.
If new genetic studies have revealed de novo mutation of CACN1A1 in patients with SHM, then it may be part of the spectrum of FHM syndrome. Neuronal calcium channel dysfunction may underlie the pathogenesis of both forms of hemiplegic migraine; the calcium-channel blocker verapamil is an effective treatment for both disorders.