Can Migraines Cause Numbness on One Side of the Body?
Yes, migraines can absolutely cause unilateral numbness—this is a well-recognized manifestation of migraine with aura, occurring in approximately 31% of individuals who experience aura symptoms. 1
Understanding Migraine-Related Numbness
Sensory Aura Characteristics
Unilateral paresthesia (pins and needles) and numbness are classic sensory aura symptoms that typically spread gradually in the face or arm. 1 These sensory symptoms:
- Usually precede the headache phase but can sometimes accompany it 1
- Are predominantly unilateral (one-sided) 1
- Spread gradually over at least 5 minutes 2
- Last between 5-60 minutes with complete resolution 2, 3
- Are transient and fully reversible 1
Prevalence and Pattern
- Approximately one-third of migraine patients experience aura symptoms 1
- While visual aura is most common (>90% of aura cases), sensory symptoms affect about 31% of those with aura 1
- The numbness can occur on the same side as the subsequent headache or on the opposite side 4
Critical Diagnostic Considerations
When Numbness Fits Migraine Pattern
The numbness is likely migraine-related when it:
- Develops gradually over 5+ minutes (not sudden onset) 2
- Resolves completely within 5-60 minutes 2, 3
- Is accompanied by other migraine features (headache, photophobia, phonophobia, nausea, visual aura) in at least 50% of episodes 5, 2
- Follows a stereotypical, recurring pattern 6, 3
Red Flags Requiring Urgent Evaluation
However, you must exclude more serious conditions when numbness presents with atypical features: 1, 2
- Sudden onset (stroke/TIA typically occurs instantly, not gradually) 2
- Persistent deficits that don't completely resolve 2
- Loss of consciousness (never occurs with migraine) 2
- New-onset symptoms in older adults without prior migraine history 2
- Symptoms lasting >72 hours 5
Clinical Approach
Essential Evaluation Steps
When a patient presents with unilateral numbness:
Document the temporal profile: Gradual onset over 5+ minutes strongly supports migraine over vascular events 2
Assess for complete reversibility: Migraine aura symptoms must fully resolve 2, 3
Look for accompanying migraine features: Headache characteristics (unilateral, pulsating, moderate-severe intensity), photophobia, phonophobia, nausea, or visual aura 1, 2
Perform physical examination to exclude other causes: This is mandatory to rule out secondary headache disorders 1
Use neuroimaging only when secondary headache disorder is suspected based on red flags or atypical presentation 1, 2
Important Pitfalls to Avoid
Don't dismiss numbness as "just anxiety" without proper evaluation—it can be a legitimate migraine aura symptom 1
Don't assume all unilateral numbness is stroke—the gradual onset and complete resolution distinguish migraine aura from TIA 2, 3
Don't overlook acephalgic migraine (aura without subsequent headache), which can occur and remains part of the migraine spectrum 2, 6
Consider vestibular migraine if numbness occurs with vertigo or dizziness, as this variant can present with diverse neurological symptoms 5, 2