MUMS; no not those mums, Migraine with Unilateral Motor Symptoms, those MUMS.

You've probably heard me talk about subtypes of Migraine before. A lot of people know the ones that have been shoved down our throat for decades, with or without aura - there are other rarer types such as Brainstem, Vestibular, Abdominal, just to name a few. I have a different subtype - I have "Migraine with Unilateral Motor Symptoms". Now when you type this into google not a lot comes up, in fact I can only find 2 studies done on MUMS, and both were done well over 10years ago.

The things we know are pretty simple; it's not a stroke - it is migraine, but it looks like a stroke. So now you're looking at me saying "So it's a hemiplegic migraine" - well no, this is what I was first diagnosed with too, but was re-classified by specialists with experience in this area. This is not to say that the 2 subtypes are not remarkable similar; in fact one study goes to say that because patients patients cannot determine the difference between "true weakness" and "give-way weakness" - it makes examination and diagnosing the 2 very difficult (Young, Gangal, Aponte & Kaiser. 2007)

Lets talk about give-way weakness; this is where you can initially provide resistance against an examiner, but suddenly no longer can, and provide no muscular resistance. Can also be called 'collapsing weakness' - as your limb may hover for a second or 2 before collapsing (Stone & Carson, 2011).

Shall we talk symptoms? I will put a disclaimer here saying this is a generalised list, and not exhaustive;

• Unilateral weakness (one-side)

• Give-way weakness

• Weakness between attacks

• Sensory Symptoms (visual, auditory, olfactory, etc)

• Head to toe "march" of symptoms - symptoms tend to start at the head

• Unilateral head pain

• Other Migrainosus symptoms, including allodynia

Peter Goadsby in 2007 wrote an article discussing MUMS; as far as I can tell this is the last time it has been mentioned. If I'm incorrect - please forward me new research! As we slowly once again move into a time where we are redefining our thinking of Migraine, to now think of it as a sensory disorder. Prof. Goadsby suggests: "...is the problem a motor complication of disordered sensory attentional mechanisms that seem a fundamental feature of migraine?" He goes on to say that with good Migraine management, and appropriate preventives, MUMS symptoms dissipate.

So that is MUMS - at least, what I can find. It's very tricky to be diagnosed with a subtype with little to know information around, but I hope that this may help you. I will go on to talk about my experience soon, but for now, this seems appropriate to start off Migraine Awareness Month 2021!

-----------

Goadsby P. J. (2007). MUMS the word. Migraine with unilateral motor symptoms: what can you say?. Journal of neurology, neurosurgery, and psychiatry, 78(6), 553. https://doi.org/10.1136/jnnp.2006.108449

Stone, J., & Carson, A. (2011). Functional Neurologic Symptoms: Assessment and Management. Neurologic Clinics, 29(1), 1-18. http://dx.doi.org/10.1016/j.ncl.2010.10.011

Young, W. B., Gangal, K. S., Aponte, R. J., & Kaiser, R. S. (2007). Migraine with unilateral motor symptoms: a case-control study. Journal of neurology, neurosurgery, and psychiatry, 78(6), 600–604. https://doi.org/10.1136/jnnp.2006.100214