Maita Hiroki, Kobayashi Tadashi, Akimoto Takashi, Osawa Hiroshi, Hanada Hiroyuki
Development of Community Healthcare, Hirosaki University Graduate School of Medicine, Aomori, Japan.
Department of General Medicine, Hirosaki University School of Medicine and Hospital, Aomori, Japan.
SAGE Open Med Case Rep. 2024 Aug 27;12:2050313X241275386. doi: 10.1177/2050313X241275386. eCollection 2024.
Hemiplegic migraine is a rare form of migraine characterized by aura with unilateral paralysis; however, studies on its treatment are limited. A 39-year-old man with migraine headaches and myofascial pain syndrome was referred to our hospital with transient right hemiplegia, after presenting to an outside emergency department with headache and right hemiplegia 2 days prior. Computed tomography, magnetic resonance imaging, and blood test results revealed no abnormalities. The symptoms resolved spontaneously; he was referred to our hospital. Based on the International Classification of Headache Disorders, Third Edition criteria, he was diagnosed with sporadic hemiplegic migraine. Propranolol was added to his regular regimen as prophylactic treatment, which resulted in reduction in his migraine frequency. Over the next 2 years, no recurrent paralysis occurred. Hemiplegic migraines should be considered in patients with migraine exhibiting transient hemiplegia without obvious intracranial abnormalities. Prophylactic treatment with propranolol could be effective in treatment of hemiplegic migraine.
偏瘫性偏头痛是一种罕见的偏头痛形式，其特征为伴有单侧麻痹的先兆；然而，关于其治疗的研究有限。一名患有偏头痛性头痛和肌筋膜疼痛综合征的39岁男性，在2天前因头痛和右侧偏瘫就诊于外部急诊科后，因短暂性右侧偏瘫被转诊至我院。计算机断层扫描、磁共振成像和血液检查结果均未发现异常。症状自行缓解；他被转诊至我院。根据《国际头痛疾病分类》第三版标准，他被诊断为散发性偏瘫性偏头痛。普萘洛尔被添加到他的常规治疗方案中作为预防性治疗，这使他的偏头痛发作频率降低。在接下来的2年里，没有再次出现瘫痪。对于有偏头痛且出现短暂性偏瘫但无明显颅内异常的患者，应考虑偏瘫性偏头痛。用普萘洛尔进行预防性治疗可能对偏瘫性偏头痛有效。
