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Cerebral blood flow changes in pseudomigraine with pleocytosis analyzed by single photon emission computed
B Fuentes1, E Diez Tejedor, J Pascual
1Department of Neurology, Hospital Universitario La Paz, Universidad Autónoma Madrid, Spain.
Abstract:
Pseudomigraine with pleocytosis is a benign and autolimited syndrome. The etiology has been related to viral infection, but its pathophysiology is not yet well identified. To investigate this point, and to see if there were changes in cerebral blood flow (as in migraine), we performed single photon emission computed tomography (SPECT) studies in four patients who fulfilled the diagnostic criteria for this syndrome. This was done during the acute phase and we repeated SPECT after resolution of the syndrome in two of them. We found a reduction in brain blood flow on the side of origin of the neurological deficits during the acute phase. This normalized after recovery of the syndrome. The finding suggests that the neurological deficits in this syndrome could be produced by a spreading depression-like mechanism similar to that proposed for migraine with aura.
Insights
Pseudomigraine with pleocytosis involves reduced brain blood flow during acute phases, potentially linked to viral infections. This cerebral blood flow reduction normalizes upon recovery, suggesting a spreading depression mechanism.
Area of Science:
- Neurology
- Neuroimaging
- Infectious Diseases
Background:
- Pseudomigraine with pleocytosis is a self-limiting condition.
- Its exact cause and underlying mechanisms remain unclear.
- Viral infections are suspected, but pathophysiology needs elucidation.
Purpose of the Study:
- To investigate the pathophysiology of pseudomigraine with pleocytosis.
- To assess cerebral blood flow changes during the acute phase.
- To compare findings with migraine mechanisms.
Main Methods:
- Single photon emission computed tomography (SPECT) was used.
- Studies were conducted during the acute phase of the syndrome.
- SPECT was repeated after symptom resolution in some patients.
Main Results:
- A reduction in brain blood flow was observed on the side of neurological deficits during the acute phase.
- Cerebral blood flow normalized after the syndrome resolved.
- This pattern was seen in the studied patients.
Conclusions:
- Neurological deficits in pseudomigraine with pleocytosis may stem from a spreading depression-like mechanism.
- This mechanism is similar to that proposed for migraine with aura.
- Findings suggest a potential link between cerebral blood flow dynamics and neurological symptoms.