The diagnostic role for susceptibility-weighted MRI during sporadic hemiplegic migraine

Area of Science:

• Neurology
• Radiology
• Pediatric Neurology

Background:

• Hemiplegic migraine, a rare migraine with aura, presents with motor weakness, making initial diagnosis difficult, particularly in sporadic cases.
• Accurate and timely diagnosis is crucial for appropriate management and to rule out other serious neurological conditions.

Observation:

• This study examined ictal magnetic resonance imaging (MRI) findings in four pediatric patients experiencing their first episode of sporadic hemiplegic migraine.
• Susceptibility-weighted imaging (SWI) identified cerebral venous prominence and increased magnetic susceptibility in brain regions correlating with neurological deficits.

Findings:

• SWI revealed abnormalities during the acute phase of hemiplegic migraine, which resolved upon patient recovery in follow-up MRIs.
• These findings suggest SWI's utility in detecting acute cerebral blood flow alterations during hemiplegic migraine episodes.

Implications:

• SWI, when used with conventional MRI sequences, offers diagnostic value for hemiplegic migraine in the acute setting.
• This imaging technique may enhance the characterization of ictal cerebral blood flow changes, aiding in the diagnosis of hemiplegic migraine.