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Updated: Jul 26, 2025

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Sporadic Hemiplegic Migraine.

Tina Kana1, Saraf Mehjabeen1, Nirav Patel1

  • 1Internal Medicine, Touro College of Osteopathic Medicine, New York City, USA.

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|June 13, 2023
PubMed
Summary

Hemiplegic migraine can mimic stroke, presenting with unilateral weakness. This case highlights a successful conservative management of sporadic hemiplegic migraine with significant symptom resolution.

Keywords:
dysphagiahemi-paresthesiahemiplegic migrainemigraine disordermotor weakness

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Area of Science:

  • Neurology
  • Neuroscience

Background:

  • Hemiplegic migraine is a rare subtype of migraine with aura.
  • It is characterized by transient unilateral neurological deficits, often hemiplegia, that mimic cerebrovascular events.
  • Distinguishing hemiplegic migraine from stroke or transient ischemic attack (TIA) is crucial for appropriate management.

Observation:

  • A 46-year-old female presented with unilateral occipital headache, dysphagia, and left-sided motor weakness.
  • Initial neuroimaging, including diffusion-weighted MRI and brain tomography, revealed no acute abnormalities.
  • The clinical presentation strongly suggested a neurological deficit mimicking stroke.

Findings:

  • Extensive workup led to a diagnosis of sporadic hemiplegic migraine.
  • Conservative management with solumedrol was initiated.
  • The patient showed a drastic improvement in symptoms following treatment.

Implications:

  • This case underscores the importance of considering hemiplegic migraine in the differential diagnosis of acute neurological deficits.
  • Conservative management strategies can be effective for sporadic hemiplegic migraine.
  • Prompt diagnosis and appropriate treatment lead to complete symptom resolution and improved patient outcomes.