Hemiplegic migraine induced by exertion

Mehrdad RAZAVI; Behzad Razavi; Deema Fattal; Adel AFIFI; Harold P ADAMS

doi:10.1001/archneur.57.9.1363

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Hemiplegic migraine induced by exertion

Mehrdad RAZAVI, Behzad Razavi, Deema Fattal, Adel AFIFI and Harold P ADAMS

Archives of neurology (Chicago), Vol.57(9), pp.1363-1365

2000

DOI: 10.1001/archneur.57.9.1363

PMID: 10987906

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Abstract

Background: It is known that exertion can aggravate migraine headache. However, the relationship between exertion and migraine aura is unknown. Objective: To study the relationship between exertion and migraine aura. Design: Case report. Setting: Tertiary care hospital. Patient: A 67-year-old man presented with recurrent attacks of exertion-induced hemiplegic migraine. Since the hemiparetic attacks were exertion induced, they were initially ascribed to recurrent transient ischemic attacks. However, the clinical picture, normal findings on cerebral angiography and neuroimaging (during the period of hemiparesis), lack of response to treatment with antiplatelets and anticoagulants, and successful treatment with verapamil suggested that the hemiparesis was not due to ischemia, but was indeed a migraine aura. We suggest that exertion induced the aura of hemiparesis by lowering the threshold for the development of cortical spreading depression. Even though our patient had no family history of hemiplegic migraine, a mutation in an ion channel gene (eg, the CACNA1A gene on chromosome 19) might account for his episodic attacks. Conclusion: Migraine aura should be included in the differential diagnosis of exertion-induced focal neurologic deficit.

Neurology

Biological and medical sciences

Vascular diseases and vascular malformations of the nervous system

Medical sciences

Details

Title: Subtitle: Hemiplegic migraine induced by exertion
Creators: Mehrdad RAZAVI - Department of Neurology, University of Iowa Hospitals and Clinics, Iowa City, United States
Behzad Razavi - Department of Medicine, University of Iowa Hospitals and Clinics, Iowa City, United States
Deema Fattal - Department of Neurology, University of Iowa Hospitals and Clinics, Iowa City, United States
Adel AFIFI - Department of Neurology, University of Iowa Hospitals and Clinics, Iowa City, United States
Harold P ADAMS - Department of Neurology, University of Iowa Hospitals and Clinics, Iowa City, United States
Resource Type: Journal article
Publication Details: Archives of neurology (Chicago), Vol.57(9), pp.1363-1365
DOI: 10.1001/archneur.57.9.1363
PMID: 10987906
NLM abbreviation: Arch Neurol
ISSN: 0003-9942
eISSN: 1538-3687
Publisher: American Medical Association; Chicago, IL
Language: English
Date published: 2000
Academic Unit: Neurology; Stead Family Department of Pediatrics; Iowa Neuroscience Institute
Record Identifier: 9984020848702771

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