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An Important Pediatric Stroke Mimic: Hemiplegic Migraine
Michael T Jurkiewicz1, Arastoo Vossough2, Avrum N Pollock2
1Department of Medical Imaging, Children's Hospital at London Health Sciences Centre, London, ON, Canada.
Childhood stroke is rare but recognized. Hemiplegic migraine (HM) mimics stroke with temporary motor weakness, but neuroimaging helps differentiate these conditions for proper management.
Area of Science:
- Neurology
- Pediatrics
- Neuroimaging
Background:
- Stroke in children, though rare, is increasingly diagnosed.
- Hemiplegic migraine (HM) is a rare migraine subtype often starting in childhood or adolescence.
- HM attacks present with migraine headaches and transient motor weakness.
Observation:
- HM symptoms develop rapidly over minutes.
- HM episodes typically resolve within an hour without lasting effects.
- HM can present with symptoms that mimic acute stroke.
Findings:
- Distinguishing HM from stroke is critical due to differing urgency and treatment.
- Neuroimaging is essential for evaluating stroke-like symptoms in the Emergency Department.
- Neuroimaging can differentiate between cerebral infarction and hemiplegic migraine.
Implications:
- Accurate diagnosis of HM versus stroke ensures appropriate patient management.
- Timely neuroimaging is key in pediatric emergency departments for stroke-like presentations.
- Understanding HM's presentation aids in avoiding misdiagnosis and unnecessary interventions.
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