Imaging abnormalities in sporadic hemiplegic migraine on conventional MRI, diffusion and perfusion MRI and MRS

Area of Science:

• Neurology
• Neuroscience
• Medical Imaging

Background:

• Hemiparetic migraine aura can present with prolonged neurological deficits.
• These symptoms may be misdiagnosed as migrainous infarction or ischemic stroke.
• Differentiating these conditions is crucial for appropriate patient management.

Observation:

• A case of prolonged hemiparesis during a migraine attack is presented.
• Initial presentation raised suspicion of migrainous infarction.
• Advanced neuroimaging techniques were employed for detailed assessment.

Findings:

• Sequential magnetic resonance imaging (MRI), magnetic resonance angiography (MRA), diffusion, perfusion imaging, and magnetic resonance spectroscopy (MRS) were performed.
• Imaging results indicated that the hemiplegia was not of vascular origin.
• The patient was diagnosed with sporadic hemiplegic migraine (SHM).

Implications:

• This case highlights the importance of advanced neuroimaging in diagnosing complex migraine presentations.
• The findings support the hypothesis that SHM mechanisms may involve cellular-level processes.
• Understanding SHM pathophysiology could lead to improved diagnostic and therapeutic strategies.