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A family with hemiplegic migraine and focal seizures
U Kramer1, T Lerman-Sagi, D Margalith
1Institute for Child Development, Tel-Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Israel.
Abstract:
Familial hemiplegic migraine is a distinctive form of migraine with autosomal dominant inheritance. The patients undergo attacks of migraine complicated by hemiplegia. Seizures have not been reported as comprising a part of this syndrome. We describe three generations of a family with hemiplegic migraine and focal seizures occurring concurrently with the migrainous attacks. There were five affected family members whose clinical features included unilateral headache and transient hemiplegia. Two family members also had focal seizures during the migrainous attacks. One of the patients was treated with carbamazepine with good results. The only associated neurological finding was ataxia which was found in the oldest patient. The presence of focal seizures during an episode of hemiplegic migraine suggests that the two phenomena of migraine and focal seizures may share the same underlying pathophysiology.
Insights
Familial hemiplegic migraine (FHM) typically does not involve seizures. This study reports a family with FHM experiencing concurrent focal seizures, suggesting shared pathophysiology.
Area of Science:
- Neurology
- Genetics
Background:
- Familial hemiplegic migraine (FHM) is an autosomal dominant migraine subtype.
- FHM attacks are characterized by migraine with transient hemiplegia.
- Seizures are not typically associated with FHM.
Observation:
- This study describes three generations of a family with FHM.
- Affected individuals experienced unilateral headache and transient hemiplegia.
- Two family members presented with focal seizures during migraine attacks.
Findings:
- Concurrent focal seizures were observed in two individuals with FHM.
- One patient with FHM and seizures responded well to carbamazepine treatment.
- Ataxia was noted in the oldest affected family member.
Implications:
- The co-occurrence of focal seizures in FHM suggests a potential shared pathophysiological basis.
- This finding expands the clinical spectrum of FHM.
- Further research into the genetic and molecular mechanisms underlying FHM and seizures is warranted.