[Functional and structural follow-up findings in complicated migraine]

Area of Science:

• Neurology
• Neuroscience
• Medical Case Reports

Background:

• Complicated migraine is a debilitating neurological condition.
• Status migrainosus, defined as a disabling migraine attack lasting longer than 72 hours, can present with severe neurological deficits.

Observation:

• A rare case of complicated migraine with a duration exceeding two weeks is presented.
• The patient exhibited severe neurological deficits including global aphasia and fluctuating right-sided hemiparesis, alongside non-localized headache.

Findings:

• Characteristic morphological and functional findings on electroencephalography (EEG), single-photon emission computed tomography (SPECT), and transcranial Doppler (TCD) aided diagnosis.
• Functional investigations, particularly SPECT and TCD, demonstrated a clear correlation with the decrease in clinical symptoms.
• Conventional imaging such as computed tomography (CT) and magnetic resonance imaging (MRT) were unspecific, and EEG did not normalize.

Implications:

• This case highlights the diagnostic utility of functional neuroimaging in prolonged complicated migraine.
• SPECT and TCD are valuable tools for monitoring treatment response and disease course in complex migraine presentations.
• Understanding these findings can improve the management of rare, severe migraine variants.