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[Pseudomigraine with pleocytosis]
B Spelsberg1, C Willert, J Machetanz
1Klinik und Poliklinik für Neurologie, Klinik und Poliklinik für Psychiatrie und Psychotherapie, Ernst-Moritz-Arndt-Universität Greifswald im Klinikum Stralsund, Rostocker Chaussee 70, 18437 Stralsund. spitzer@mail.uni-greifswald.de
Abstract:
We report two cases of male patients aged 32 and 34 presenting with headache, neurological deficits, and fever. Neither the patients nor their families had a history of migraine. Analysis of the CSF revealed lymphocytic pleocytosis, but no causative infectious agent could be identified. During the attacks, EEG showed focal slowing and was normal afterwards. Computed tomography, MRI, Doppler sonography, and routine blood parameters were normal. In both patients, the focal deficits and the headache vanished within a few hours. We diagnosed a pseudomigraine with pleocytosis (PMP), recently described as an entity. This disorder is characterized by brief relapsing attacks with headache, nausea, vomiting, focal neurological deficits, and a lymphocytic pleocytosis in the CSF. The differentiation from vascular disorders is important because angiography should be avoided due to a high rate of complications in patients with PMP.
Insights
Two young men experienced brief neurological episodes with fever and headache. Doctors diagnosed pseudomigraine with pleocytosis, a rare condition.
Area of Science:
- Neurology
- Neuroscience
Background:
- The abstract discusses a rare neurological condition.
- It highlights the importance of accurate diagnosis in neurological disorders.
Observation:
- Two male patients, aged 32 and 34, presented with acute headache, fever, and transient focal neurological deficits.
- Cerebrospinal fluid (CSF) analysis revealed lymphocytic pleocytosis without an identifiable infectious agent.
- Electroencephalogram (EEG) showed focal slowing during attacks, normalizing afterward. Standard neuroimaging and blood tests were unremarkable.
Findings:
- The patients were diagnosed with pseudomigraine with pleocytosis (PMP), a recently described neurological entity.
- PMP is characterized by recurrent, short-lived attacks of headache, nausea, vomiting, focal neurological deficits, and CSF lymphocytic pleocytosis.
- The condition resolved spontaneously within hours in both reported cases.
Implications:
- Accurate differentiation of PMP from vascular disorders is crucial.
- Angiography should be approached with caution in suspected PMP cases due to potential complications.
- This case report contributes to the understanding of PMP and its clinical presentation.