Hemiplegic migraine
ICD-10 G43.4 is a billable code used to indicate a diagnosis of hemiplegic migraine.
Hemiplegic migraine is a rare and severe form of migraine characterized by temporary paralysis or weakness on one side of the body (hemiplegia) that can occur before, during, or after a migraine attack. This condition is often accompanied by typical migraine symptoms such as severe headache, nausea, vomiting, and sensitivity to light and sound. The hemiplegic symptoms can mimic those of a stroke, making it crucial for healthcare providers to differentiate between the two. Hemiplegic migraine can be familial, meaning it runs in families, or sporadic, occurring without a family history. The pathophysiology involves genetic mutations affecting ion channels, leading to altered neuronal excitability and vascular changes. Triggers for hemiplegic migraine can include stress, hormonal changes, certain foods, and environmental factors. Preventive treatments may involve medications such as beta-blockers, anticonvulsants, and calcium channel blockers, while acute treatments may include triptans or non-steroidal anti-inflammatory drugs (NSAIDs). Due to its complexity and potential for misdiagnosis, accurate coding and thorough documentation are essential.
Detailed neurological examination findings, family history of migraines, and treatment response.
Patients presenting with unilateral weakness during migraine attacks, family history of hemiplegic migraines.
Neurologists must ensure clear differentiation from stroke and document all neurological assessments.
Comprehensive patient history, including migraine triggers and previous treatments.
Patients with recurrent headaches and episodes of unilateral weakness.
Primary care providers should refer to specialists for complex cases and document all referrals.
Used for follow-up visits for patients with hemiplegic migraine.
Document history of present illness, review of systems, and treatment response.
Neurologists may require more detailed neurological assessments.
Common triggers include stress, hormonal changes, certain foods (like aged cheeses and processed meats), and environmental factors such as bright lights or strong odors.
