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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.
Not to be confused with Spastic hemiplegia. Hemiparesis is unilateral paresis, that is, weakness of the entire left or right side of the body (hemi- means half). Hemiplegia is, in its most severe form, complete paralysis of half of the body. Hemiparesis and hemiplegia can be caused by different medical conditions, including congenital causes, trauma, tumors, or stroke.