Pseudomigraine with lymphocytic pleocytosis

Area of Science:

• Neurology
• Immunology
• Neuroscience

Background:

• Pseudomigraine with temporary neurologic symptoms and lymphocytic pleocytosis is a rare, self-limited neurological syndrome of unknown etiology.
• Characterized by recurrent episodes of headache, transient neurological deficits, and cerebrospinal fluid (CSF) lymphocytosis.

Purpose of the Study:

• To describe the clinical characteristics, diagnostic findings, and potential pathophysiology of pseudomigraine with temporary neurologic symptoms and lymphocytic pleocytosis.

Main Methods:

• Review of clinical cases presenting with headache, transient neurological symptoms, and CSF lymphocytosis.
• Analysis of patient demographics, symptom profiles, headache characteristics, and neurological deficits.
• Evaluation of laboratory findings including CSF analysis, neuroimaging (CT, MRI), EEG, and SPECT.

Main Results:

• The syndrome affects individuals aged 15-40, predominantly males, with 1-12 episodes.
• Common symptoms include sensory disturbances (78%), aphasia (66%), and motor deficits (56%), with headaches lasting a mean of 19 hours.
• CSF shows lymphocytic pleocytosis and elevated protein, while neuroimaging is typically normal; EEG and SPECT may show abnormalities.

Conclusions:

• The syndrome is characterized by transient neurological deficits and lymphocytic pleocytosis, distinct from typical migraine.
• A potential autoimmune mechanism involving immune system activation secondary to viral infection, leading to aseptic leptomeningeal vasculitis, is hypothesized.
• Further research is needed to elucidate the exact cause and optimize management strategies for this rare condition.