Abstract
Keywords
A 29-year-old woman was admitted with aphasia, right-sided hemiparesis and headache. She has familial hemiplegic migraine (FHM) ATP1A2 T376M mutation. MRI showed left cortical hypersignal only on FLAIR. Weakness recovered in 24 hours, but an atypical aphasia with fluctuating fluency lasted 3 weeks. EEG showed no paroxysmal activity. MRI normalized in 1 month (Figure 1).
Cranial MRI.
First FHM attacks may be misdiagnosed. While DWI associated with FLAIR changes are compatible with ischemia, isolated acute FLAIR changes can help identify FHM or status epilepticus. The parallel course of symptoms and cortical vasogenic edema (1) supports the cortical spreading depression pathogenesis of migraine aura (2,3).
Footnotes
Declaration of conflicting interests
The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Funding
The authors received no financial support for the research, authorship, and/or publication of this article.