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3D-Neuronavigation In Vivo Through a Patient's Brain During a Spontaneous Migraine Headache
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Migraine-induced epistaxis and sporadic hemiplegic migraine: unusual features in the same patient

José Barros1, Joana Damásio, Assunção Tuna

  • 1Hospital de Santo António, Centro Hospitalar do Porto, Porto, Portugal.

Case Reports in Neurology
|July 19, 2012
PubMed
Abstract

Insights

This case study reports a rare instance of migraine-induced epistaxis with aura, highlighting the potential for bilateral brain involvement during migraine aura. Further investigation into guided anamnesis is suggested for similar cases.

Area of Science:

  • Neurology
  • Neuroscience

Background:

  • Epistaxis and migraine have been anecdotally linked since the 19th century.
  • Sporadic hemiplegic migraine is a rare subtype characterized by reversible motor deficits.
  • Few contemporary cases link epistaxis and migraine, particularly with aura.

Observation:

  • A 47-year-old male experienced epistaxis during the resolution phase of migraine with scintillating scotoma.
  • He later developed complex auras with transient aphasia and hemiplegia, inconsistent with typical neurological findings.
  • Genetic testing for common migraine-related mutations was negative.

Findings:

  • This is the first reported case of migraine-induced epistaxis associated with aura.
  • The complex aura's topography suggests bilateral, uneven, and selective spreading depression.
  • Late-onset complex auras may indicate interactions between genetic predisposition and environmental factors.

Implications:

  • Highlights the importance of detailed patient history (anamnesis) in identifying rare migraine presentations.
  • Suggests a broader understanding of migraine aura pathophysiology, potentially involving bilateral cortical spreading depression.
  • Emphasizes the need to consider complex environmental and genetic interactions in late-onset neurological disorders.
Keywords:
EpistaxisMigraine with auraSporadic hemiplegic migraineSpreading depression

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