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Head tremor related to CACNA1A mutations
Rianne P J Geerlings1, Peter J Koehler, Danielle Y P Haane
1Department of Neurology, Atrium Medical Centre, Heerlen, The Netherlands.
Insights
Familial hemiplegic migraine (FHM) can present with symptoms beyond hemiplegia. CACNA1A gene mutations, linked to FHM, may cause other neurological issues like head tremors.
Area of Science:
- Neurology
- Genetics
Background:
- Familial hemiplegic migraine (FHM) involves migraines with transient hemiplegia, linked to CACNA1A, ATP1A2, and SCN1A gene mutations.
- FHM patients may exhibit additional symptoms like epilepsy and cerebellar dysfunction.
Observation:
- Two patients presented with unexplained head tremors, not hemiplegic attacks.
- Genetic analysis revealed CACNA1A gene mutations in both patients.
Findings:
- CACNA1A mutations are associated with neurological symptoms beyond typical FHM presentations.
- Head tremors can be a presenting symptom in individuals with CACNA1A mutations.
Implications:
- This expands the known clinical spectrum of CACNA1A-related disorders.
- Highlights the importance of genetic testing for CACNA1A mutations in patients with unexplained neurological symptoms, including head tremors.
Introduction:
Familial hemiplegic migraine (FHM) is characterized by the familial occurrence of migraine attacks with fully reversible transient hemiplegia. Mutations in three different genes have been identified; CACNA1A (FHM1), ATP1A2 (FHM2) and SCN1A (FHM3). Besides hemiplegia, several other symptoms have been described in FHM 1-3 mutation carriers, including epilepsy and cerebellar symptoms.
Case Report:
We describe two patients in whom hemiplegic attacks were not the presenting symptom, but in whom an otherwise unexplained head tremor led us to search for FHM mutations. Both patients carried a mutation in the CACNA1A gene.
Discussion:
CACNA1A mutations can give significant symptoms other than (hemiplegic) migraine as reason for presentation.
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