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[Migraine with pleocytosis: a case of atypical progression]

S Santos1, B Sierra Bergua, I de los Mártires Armingol

  • 1Hospital Clinico Universitario Lozano Blesa, Zaragoza, España. ssantosl@yahoo.com

Revista De Neurologia
|March 19, 2004
PubMed
Abstract

Insights

This case study highlights a rare form of migraine with cerebrospinal fluid pleocytosis presenting with atypical neurological deficits. Corticosteroid treatment proved effective in managing symptoms and normalizing cerebrospinal fluid in this migraine variant.

Area of Science:

  • Neurology
  • Neuroimmunology

Background:

  • Migraine with cerebrospinal fluid pleocytosis (MP) is characterized by headaches, transient neurological deficits, and lymphocytic pleocytosis.
  • This condition typically resolves spontaneously.

Observation:

  • A 27-year-old male presented with severe headaches and transient neurological deficits including dysphasia and hemiparesis.
  • Cerebrospinal fluid analysis revealed significant lymphocytosis and elevated intracranial pressure (ICP).
  • Atypical progression included right lateral rectus muscle paresis secondary to intracranial hypertension.

Findings:

  • Standard investigations for infectious, autoimmune, and vascular causes were negative.
  • Treatment with prednisone (1 mg/kg/day) led to clinical remission and normalization of CSF parameters within two months.
  • The patient experienced resolution of neurological deficits and headaches.

Implications:

  • This case suggests that corticosteroids may be a viable treatment option for atypical presentations of migraine with pleocytosis.
  • The findings challenge the assumption of benignity in all MP cases, especially those with unusual progression.
  • Further research into the immunomodulatory aspects of MP and corticosteroid efficacy is warranted.

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