Unusual Clinical Picture in Migraine – Case Reports

Czech version

Authors: R. Kotas ¹; J. Kastner ²; V. Amblerová ¹; J. Rokytová ¹; H. Vacovská ¹; J. Polívka ¹; J. Kobr ³; A. Malán ⁴
Authors‘ workplace: FN Plzeň Neurologická klinika LF UK v Plzni ¹; FN Plzeň Radiodiagnostická klinika LF UK v Plzni ²; FN Plzeň Dětská klinika LF UK v Plzni ³; FN Plzeň Oddělení nukleární medicíny ⁴
Published in: Cesk Slov Neurol N 2010; 73/106(2): 178-186
Category: Case Report

Overview

This paper deals with two unusual clinical pictures of migraine. In the first case report, a 10‑year-old boy suffered from an attack of hemiplegic migraine with headache and left-sided hemiplegia with persistent aura without infarction, and recovered almost completely within 6 months of onset. Repeated conventional magnetic resonance imaging revealed no structural lesion of the brain, merely a subsiding light hypoperfusion in the frontal precentral regions bilaterally evident in perfusion‑weighted imaging. Findings in diffusion-weighted imaging and ADC maps were repeatedly normal. Examination of cerebral blood flow with single proton emission computed tomography was repeatedly normal. In the second case report, a 14‑year‑old boy suffered from a severe attack of migraine accompanied by delirium. Subarachnoid haemorrhage, meningitis and other structural lesions of the CNS were ruled out, while a toxicological examination, including alcohol, proved normal. The patient recovered within 12 hours.

Key words:
hemiplegic migraine – persistent aura without infarction – migraine with delirium

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