The digiti quinti sign in hemiplegic migraine.
The digiti quinti sign (DQS), described originally as a clinical indication of subtle motor deficit, consists of a relatively greater abduction of the fifth finger on the affected side when both arms are extended forwards. This sign was previously observed interictally in three consecutive hemiplegic migraine (HM) patients.


METHODS
To verify whether the DQS specifically discriminates HM from non-hemiplegic migraine (nHM), the angle between the fourth and fifth fingers (ANG) was measured interictally in 10 HM patients, 44 migraine with aura and migraine without aura patients, and 45 healthy controls.


RESULTS
The ANG was significantly wider at the symptomatic side in HM as compared with nHM and controls. The differences between the symptomatic and non-symptomatic (for HM) or between the right and left sides (absolute values for nHM and controls) were, respectively, 10.10° ± 9.58°, 4.15° ± 3.95° and 5.37° ± 4.74° (p = .007). The optimal cutoff point for ANG was 15° at the symptomatic side (sensitivity and specificity of 80.0% and 72.2%, respectively), 10.5° at the non-symptomatic side (sensitivity and specificity of 60.0% and 52.3%), and 3° for the difference between sides (sensitivity and specificity of 90.0% and 79.5%).


CONCLUSIONS
Data show that the DQS discriminates HM from nHM and controls.
Vincent
Maurice B
MB
Universidade Federal do Rio de Janeiro, Av. das Américas 1155, Rio de Janeiro, Brazil. vincent@ufrj.br
Carvalho-e-Silva
Fernanda M L
FM
Luiz
Ronir R
RR
D000328:Adult; D005260:Female; D005385:Fingers / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008881:Migraine Disorders / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology; D018908:Muscle Weakness / Q000209:etiology; D012372:ROC Curve; D012680:Sensitivity and Specificity