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Updated: Jul 30, 2026

3D-Neuronavigation In Vivo Through a Patient's Brain During a Spontaneous Migraine Headache
Published on: June 2, 2014
Hemiplegic migraine during pregnancy: unusual magnetic resonance appearance with SPECT scan correlation
P J Barbour1, J E Castaldo, E I Shoemaker
1Department of Medicine, Division of Neurology, Lehigh Valley Hospital, Allentown, PA 18103, USA.
Objective:
This article discusses the pathophysiology and implications for treatment of hemiplegic migraine within a case study presentation.
Background:
We evaluated a 31-year-old white woman for hemiplegia in her 36th week of pregnancy. She initially presented with severe headache, dysarthria, lethargy, and left-sided numbness and weakness. Hemiplegic migraine remains a diagnosis made by exclusion; neurologic examination of these patients is localizing, but nonspecific.
Design:
Magnetic resonance imaging and single photon emission computed tomography scanning were performed on this patient during an exacerbation of headache associated with dense hemiplegia.
Results:
Magnetic resonance imaging showed a superficial cerebral hemispheric signal abnormality with enhancement. Single photon emission computed tomography scanning confirmed hyperperfusion of that hemisphere.
Conclusions:
We believe the imaging evidence in our patient suggests that hemiplegia was caused and sustained by hyperperfusion. This case lends supportive evidence to a primarily vasodilatory mechanism and hyperperfusion as an etiology of the paralysis in such headaches and perhaps migraine with aura.
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