This 33-year-old teacher came to our emergency ward due to headache and speech difficulties. One hour earlier he had told his wife that he noticed headache, “I feel all my head pulsating darling”. He took a paracetamol pill and went to bed. Twenty minutes later her wife found him agitated and with an incoherent and unintelligible speech. His wife called the emergency services and stroke code was activated. When he arrived he was conscious but tended to remain with his eyes closed and with his hands on his head. Global aphasia was evident and there seemed to be a slight motor weakness of his right extremities, where an indifferent plantar response was obtained. There were no apparent hemianopsia, meningeal signs, and abnormalities in the cranial nerves, including optic fundi, or in the neurovascular examination. Systemic examination was unremarkable, except for a slight axillary temperature elevation (37.6 °C). His blood pressure was 115/067 mmHg. Her wife explained us that 2 days earlier he had visited his GP due to an episode of pulsating headache, which lasted about 5 h and was accompanied by some feeling of numbness in his right hemibody. He was already asymptomatic and his physical exam was normal. His GP thought he had experienced a migraine attack with aura and gave an appointment for his neurologist specialist in 3 weeks.
Left Hemisphere Migraine Attack Computerise Tomography Migraine With Aura Brain SPECT
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Bartelson JD, Swanson JW, Whisnant JP (1981) A migrainous syndrome with cerebrospinal fluid lymphocytosis. Neurology 31:1257–1262CrossRefGoogle Scholar
Berg MJ, Williams LS (1995) The transient syndrome of headache with neurologic deficits and CSF lymphocytosis. Neurology 45:1648–1654PubMedCrossRefGoogle Scholar
Chapman KM, Szczygielski BI, Toth C et al (2003) Pseudomigraine and lymphocytic pleocytosis: calcium channelopathy? Clinical description of 10 cases and genetic analysis of the familial hemiplegic migraine gene CACNA1A. Headache 43:892–895PubMedCrossRefGoogle Scholar
Gomez-Aranda F, Canadillas F, Marti-Massó JF et al (1997) Pseudomigraine with temporary neurological symptoms and lymphocytic pleocytosis: a report of 50 cases. Brain 120:1105–1113PubMedCrossRefGoogle Scholar
Guillan M, Alonso-Canovas A, González-Valcarcel J et al (2012) Stroke mimics treated with thrombolysis: further evidence on safety and distinctive clinical features. Cerebrovasc Dis 34:115–1120PubMedCrossRefGoogle Scholar
Headache Classification Subcommittee of the International Headache Society (2013) The International Classification of Headache Disorders ICHD-III, beta version. Cephalalgia 33:629–808CrossRefGoogle Scholar
Kurtuncu M, Kaya D, Zuliani L et al (2013) CACNA1H antibodies associated with headache with neurological deficits and cerebrospinal fluid pleocytosis (HaNDL). Cephalalgia 32:123–129CrossRefGoogle Scholar
Pascual J, Valle N (2013) Pseudomigraine with lymphocytic pleocytosis. Curr Pain Headache Rep 7:224–228CrossRefGoogle Scholar