Related Experiment Video

Updated: May 21, 2026

3D-Neuronavigation In Vivo Through a Patient's Brain During a Spontaneous Migraine Headache
10:39

3D-Neuronavigation In Vivo Through a Patient's Brain During a Spontaneous Migraine Headache

Published on: June 2, 2014

Psychotic aura symptoms in familial hemiplegic migraine type 2 (ATP1A2)

José Barros1, Alexandre Mendes, Ilda Matos

  • 1Serviço de Neurologia, Hospital de Santo António (HSA), Centro Hospitalar do Porto (CHP), Largo Professor Abel Salazar, 4099-001 Porto, Portugal, josebarros.neuro@hgsa.min-saude.pt

The Journal of Headache and Pain
|June 5, 2012
PubMed
Abstract

Insights

Familial hemiplegic migraine type 2 (FHM type 2) can present with psychotic symptoms, challenging previous understandings. This rare presentation requires considering FHM type 2 in the differential diagnosis of acute psychosis.

Area of Science:

  • Neurology
  • Genetics

Background:

  • Familial hemiplegic migraine (FHM) typically presents with neurological deficits.
  • Psychotic symptoms are exceptionally rare in FHM, with no prior reports in FHM type 2 (ATP1A2) mutations.

Observation:

  • A family with FHM phenotype due to an ATP1A2 M731T mutation was studied over 10 years.
  • Two siblings experienced complex migraine auras with psychotic features, including time travel delusions and paranoia.

Findings:

  • The study identified a novel association between FHM type 2 and the manifestation of acute psychotic symptoms.
  • Complex auras in FHM type 2 can encompass elaborate illusions and delusional beliefs.

Implications:

  • FHM type 2 should be considered in the differential diagnosis for patients presenting with acute psychosis and a history of migraine aura.
  • This expands the known clinical spectrum of FHM type 2, highlighting the importance of genetic testing in complex migraine cases.

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