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The weakness that characterizes hemiplegic migraine is a manifestation of motor aura. The aura of hemiplegic migraine is most probably caused by cortical spreading depression, a self-propagating wave of neuronal and glial depolarization that spreads across the cerebral cortex.
After years of expensive dental work my neurosurgeon diagnosed facial migraines when my daughter was 20. 20 years of pain and not knowing what was causing it. The migraine medications (like Imitrex) is the only thing that will stop them. I find when I get real hot is one of the big causes of my facial migraines.