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Unusual Presentation of a Hemiplegic Migraine in a Seven-Year-Old Child: A Case Report
Mohamad B Alebaji1, Maryam A Ani1, Suad A Rozieh1
1Department of Academic Affairs, Tawam Hospital, Al Ain, ARE.
Insights
A seven-year-old boy with a rare genetic disorder experienced hemiplegic migraine, presenting with temporary weakness and severe headache. This case highlights the importance of considering hemiplegic migraine in children with underlying conditions.
Area of Science:
- Pediatric Neurology
- Neurogenetics
Background:
- Headache is a common symptom in children, with migraine frequently being the diagnosis.
- Hemiplegic migraine presents with aura and temporary unilateral weakness, typically without permanent neurological deficits.
Observation:
- A seven-year-old male with proximal tubular dysfunction (homozygous SLC4A4 gene mutation) presented with one-day right-sided weakness.
- Following discharge, he developed severe left-sided headache, photophobia, phonophobia, and fever.
- Radiology and lab work were normal; encephalitis was excluded.
Findings:
- The patient was diagnosed with hemiplegic migraine based on clinical presentation and history.
- This diagnosis was made despite the patient's underlying genetic condition.
Implications:
- This case underscores the need to consider hemiplegic migraine in pediatric patients with neurological symptoms, even those with pre-existing genetic disorders.
- Accurate diagnosis is crucial for appropriate management and ruling out other serious conditions like encephalitis.
Abstract:
In the pediatric population, headache is a common presenting symptom, and migraine is often the diagnosis. A hemiplegic migraine is characterized by an aura and sudden-onset weakness on one side of the body that usually resolves without causing any permanent neurological damage. In this case, we present a seven-year-old male child with a known case of proximal tubular dysfunction (homozygous mutation in the SLC4A4 gene) who presented to the emergency department with a one-day history of weakness on the right side of his body. A few hours after being discharged from the hospital, he began complaining of a severe headache on the left side, accompanied by photophobia, phonophobia, and high fever. Radiology scans and laboratory workup were unremarkable, and encephalitis was ruled out. He was later diagnosed with hemiplegic migraine based on his history and clinical presentation.
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