[Familial hemiplegic migraine resulting in recurrent coma].
A 71-year-old woman presented with recurrent episodes of headache accompanied by hemihypoesthesia, fever, aphasia, reduced consciousness and worsening of pre-existing ataxia. Brain imaging revealed atrophy of the cerebellum. The white cell count in the cerebrospinal fluid was slightly increased. The patient had a family history of migraine and cerebellar ataxia. DNA testing revealed a missense mutation in the CACNA1A gene, confirming the diagnosis of familial hemiplegic migraine. Familial hemiplegic migraine is a rare subtype of migraine with aura. It follows an autosomal dominant pattern of inheritance. Patients with familial hemiplegic migraine exhibit a wide spectrum of symptoms, which can hinder the diagnosis. If a patient presents with recurrent coma or encephalitis with or without cerebellar ataxia, familial hemiplegic migraine should be included in the differential diagnosis.
Lee
H
H
Medisch Centrum Alkmaar, afd. Neurologie, Alkmaar. h.lee@elisabeth.nl
Aramideh
M
M
Ginjaar
H B
HB
D000368:Aged; D015220:Calcium Channels / Q000235:genetics*; D003128:Coma / Q000175:diagnosis / Q000209:etiology; D004252:DNA Mutational Analysis; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D020325:Migraine with Aura / Q000175:diagnosis* / Q000235:genetics*; D012008:Recurrence; D020864:Calcium Channels, N-Type
D015220:Calcium Channels; C105656:CACNA1A protein, human; D020864:Calcium Channels, N-Type