Name: | Description: | Size: | Format: | |
---|---|---|---|---|
608.43 KB | Adobe PDF |
Advisor(s)
Abstract(s)
Abstract
Background: Since the mid-19th century, epistaxis and migraine have been occasionally
associated with each other. Nevertheless, we found only two cases in the contemporary
medical literature. Sporadic hemiplegic migraine is a subtype of migraine with reversible
motor deficits, without similar episodes in relatives.
Case: We describe a 47-year-old male with a history of migraine with a scintillating scotoma
starting at the age of 20. In some of the episodes, he developed epistaxis in the resolution
phase of migraine. At the age of 35, he experienced a visual aura followed by transient
aphasia, left crural weakness and headache. Contralateral similar episodes occurred in the
subsequent months. Neurological examination and MRI were normal. Mutations in
CACNA1A, ATP1A2, SCN1A and NOTCH3 were excluded.
Discussion: Three distinct aspects deserve our consideration. This is the first report of
migraine-induced epistaxis involving aura; the scarcity of similar reports may be due to the
lack of a guided anamnesis. The complex aura presented had a peculiar topography,
inconsistent with the classical analytical neurological semiology. This may suggest that the
spreading depression affects the brain bilaterally but in an uneven and elective manner.
Lastly, the present report conveys that the late appearance of complex auras requires
improbable interactions between environmental and endogenous conditions in individuals
with a genetic predisposition.
Description
Keywords
Epistaxis Migraine with aura Sporadic hemiplegic migraine Spreading depression
Citation
Case Rep Neurol 2012;4:116–119
Publisher
Karger