Lemka Małgorzata, Pilarska Ewa, Szmuda Marta, Pienczk-Recławowicz Karolina
Klinika Neurologii Rozwojowej, Gdański Uniwersytet Medyczny, ul. Debinki 7, 80-952 Gdańsk.
Neurol Neurochir Pol. 2009 Nov-Dec;43(6):579-83.
Hemiplegic migraine is a specific form of migraine with aura including hemiparesis. It is a rare condition of unclear aetiology. The authors present a case of a 14-year-old boy with persistent foramen ovale, suffering from sporadic hemiplegic migraine. The authors broadly describe the symptoms and types of hemiplegic migraine as well as underlining diagnostic and therapeutic difficulties of the attacks. The patient suffered from recurrent severe headaches, vomiting and co-existing focal neurological symptoms, including alternant hemiparesis. On the basis of the history, thorough clinical observation and numerous accessory investigations a diagnosis of sporadic hemiplegic migraine was established. However, the last attack, with prolonged neurological deficits, was treated as a complication of migraine and defined as persistent aura without infarction. The authors also broadly discuss a differential diagnosis, including other stroke-like incidents, vascular diseases, immunological and mitochondrial disorders that mimic the symptoms and clinical course of sporadic hemiplegic migraine.
偏瘫性偏头痛是偏头痛伴先兆的一种特殊形式，包括偏瘫。这是一种病因不明的罕见病症。作者报告了一例患有持续性卵圆孔未闭的14岁男孩，其患有散发性偏瘫性偏头痛。作者广泛描述了偏瘫性偏头痛的症状和类型，并强调了发作时的诊断和治疗困难。该患者反复出现严重头痛、呕吐，并伴有局灶性神经症状，包括交替性偏瘫。根据病史、全面的临床观察和大量辅助检查，确诊为散发性偏瘫性偏头痛。然而，最后一次发作伴有长期神经功能缺损，被视为偏头痛的并发症，并定义为无梗死的持续性先兆。作者还广泛讨论了鉴别诊断，包括其他类似中风的事件、血管疾病、免疫性疾病和线粒体疾病，这些疾病可模仿散发性偏瘫性偏头痛的症状和临床过程。
