Abstract
Hemiplegic migraine (HM) is a rare migraine with aura; it can be familiar or sporadic. A 46-years-old man presented left migraine followed by right hemiparesis with bilateral plantar flexion of cutaneous plantar reflex (CPR). Brain CT and CT-angiography were normal. The next day patient got worse. The EEG showed left fronto-temporal cuspidate delta waves and brain MRI showed a minimal hyperintensity at T2-sequences in the left frontal cortex with a minor representation of the cortical veins at susceptibility weighted imaging sequences. After 3 days, he had a progressive neurological improvement. After 2 weeks, EEG and brain MRI were normal. He was discharged with diagnosis of probably first attack of sporadic HM and after 8 months he was asymptomatic. The normal CPR on the hemiplegic side might be a clinical marker of functional hemiplegia. For the international classification of headache disorder (ICHD-3) two attacks are necessary for HM diagnosis. We propose for the first attack of HM to make diagnosis of “probable” HM as expected to the same ICHD-3 for migraine. Further studies are necessary to support our hypotheses.
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References
Fedak EM, Zumberge NA, Heyer GL (2013) The diagnostic role for susceptibility-weighted MRI during sporadic hemiplegic migraine. Cephalalgia 33(15):1258–1263
Bosemani T, Burton VJ, Felling RJ, Leigh R, Oakley C, Poretti A, Huisman TAGM (2014) Pediatric hemiplegic migraine: role of multiple MRI techniques in evaluation of reversible hypoperfusion. Cephalalgia 34(4):311–315
Ducros A, Denier C, Joutel A et al (2001) The clinical spectrum of familial hemiplegic migraine associated with mutation in a neuronal calcium channel. N Engl J Med 345:17
Thomsen LL, Eriksen MK, Roemer SF et al (2002) A population-based study of familial hemiplegic migraine suggests revised diagnostic criteria. Brain 125:1379
Thomsen LL, Ostergaard E, Olesen J, Russell MB (2003) Evidence for a separate type of migraine with aura: sporadic hemiplegic migraine. Neurology 60:595
Haacke EM, Mittal S, Wu Z et al (2009) Susceptibility-weighted imaging: technical aspects and clinical applications, part 1. Am J Neuroradiol 30:19–30
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Ferrante, E., Prone, V., Longoni, M. et al. Stroke-like attack: first episode of sporadic hemiplegic migraine. Neurol Sci 38 (Suppl 1), 189–191 (2017). https://doi.org/10.1007/s10072-017-2873-1
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DOI: https://doi.org/10.1007/s10072-017-2873-1