title: Sporadic hemiplegic migraine with normal imaging as the initial manifestation of CADASIL.
abstract: BACKGROUND
  Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) can be present with negative family history and, especially in younger patients, with normal brain magnetic resonance. For this reason, those CADASIL patients that present only with migraine may be misdiagnosed. In the case of migraine with motor aura, sporadic hemiplegic migraine (SHM) is one of the possible misdiagnoses.
  
  
  METHODS
  We present a case of a patient who, in the first years of her disease, met the clinical criteria for SHM. A diagnosis of CADASIL was considered only when her sister presented with headache and an unknown leukoencephalopathy.
  
  
  CONCLUSIONS
  This case illustrates the need for a careful review of the clinical and family history during the follow-up of primary headaches.
authors.affiliation: Hospital de Santo António, Centro Hospitalar do Porto, Portugal.
authors.forename: Cecília
authors.initials: C
authors.lastname: Monteiro
authors.forename: José
authors.initials: J
authors.lastname: Barros
authors.forename: Ricardo
authors.initials: R
authors.lastname: Taipa
authors.forename: José
authors.initials: J
authors.lastname: Pereira-Monteiro
mesh_terms: D000328:Adult; D046589:CADASIL / Q000150:complications* / Q000175:diagnosis* / Q000235:genetics; D005260:Female; D006801:Humans; D008881:Migraine Disorders / Q000209:etiology*; D010375:Pedigree