A migrainous syndrome with cerebrospinal fluid pleocytosis

Abnormalities of cerebrospinal fluid (CSF) are rare in migraine, even when accompanied by focal neurologic signs and symptoms. Seven patients without a prior history of migraine experienced a limited series of migraine-like attacks associated with abnormalities of the CSF. The episodic, severe headaches were preceded and accompanied by sensory, motor, speech, and visual disturbances. The CSF showed a predominantly lymphocytic pleocytosis, increased protein, and elevated opening pressure. All seven patients recovered completely. We postulate that the migrainous episodes were symptomatic of an underlying inflammatory disorder of the central nervous system. This distinctive combination of symptoms and CSF findings constitutes a benign syndrome.