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Benign migraine-like syndrome with CSF pleocytosis in children
Insights
Cerebrospinal fluid (CSF) pleocytosis is usually secondary to complicated migraine attacks in children. In rare instances, infections may trigger both migraine and CSF pleocytosis.
Area of Science:
- Neurology
- Pediatrics
- Neuroimmunology
Background:
- Complicated migraine is a neurological disorder characterized by transient neurological deficits.
- Cerebrospinal fluid (CSF) analysis is crucial in diagnosing neurological conditions.
- The relationship between migraine and CSF abnormalities requires further elucidation.
Observation:
- Four pediatric cases with complicated migraine presented with CSF pleocytosis.
- Pleocytosis was predominantly lymphocytic (3/4 cases), with one case showing polymorphonuclear cells.
- CSF abnormalities were recurrent in one patient during separate migraine attacks.
Findings:
- CSF pleocytosis is generally a secondary phenomenon during complicated migraine attacks.
- This finding is supported by the current cases and a review of 23 previously reported cases.
- In rare situations, infections can manifest as both migraine attacks and CSF pleocytosis.
Implications:
- The findings suggest that CSF pleocytosis in children with complicated migraine is typically reactive, not indicative of infection.
- This understanding can aid in differential diagnosis, distinguishing migraine from infectious mimics.
- Further research may explore the specific mechanisms linking migraine and inflammatory responses in the CNS.
Abstract:
Four children with symptoms consistent with complicated migraine had CSF pleocytosis, in three cases lymphocytic and in the fourth polymorphonuclear. In one case the CSF abnormality was found during two separate attacks of complicated migraine. On the basis of the 23 cases reported in the literature and these four personal cases, the authors conclude that, as a rule, pleocytosis is a secondary phenomenon of an attack of complicated migraine. However, in exceptional cases an infectious disease might produce both a migraine attack and CSF pleocytosis.