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Sporadic hemiplegic migraine with seizures and transient MRI abnormalities

Harsha Bhatia1, Fawzi Babtain

  • 1Department of Neurology, Aseer Central Hospital, Abha, Saudi Arabia.

Case Reports in Neurological Medicine
|September 1, 2012
PubMed

Insights

Sporadic hemiplegic migraine, a rare neurological disorder, can present with seizures and temporary brain changes. These MRI findings suggest prolonged neuronal depolarization, not stroke, resolving over time.

Area of Science:

  • Neurology
  • Neuroimaging
  • Migraine Disorders

Background:

  • Hemiplegic migraines involve migraine with aura and temporary motor weakness.
  • Familial and sporadic subtypes are distinct entities per the International Classification of Headache Disorders (ICHD-II).
  • Sporadic hemiplegic migraine is a rare migraine variant.

Observation:

  • A case of sporadic hemiplegic migraine with seizures was observed.
  • MRI revealed cortical hyperintensity and edema on T2/FLAIR images.
  • No diffusion restriction pattern was noted on MRI.

Findings:

  • Observed MRI changes completely resolved over time.
  • These transient changes suggest prolonged neuronal depolarization.
  • The findings indicate the changes are not of ischemic origin.

Implications:

  • This case deepens understanding of sporadic hemiplegic migraine pathophysiology.
  • It highlights the importance of neuroimaging in differentiating migraine-related changes from stroke.
  • The resolution of MRI abnormalities supports a functional, non-ischemic mechanism.

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