Familyal Hemiplejik Migren- Olgu Sunumu

Abstract

Hemiplejik migrenin uluslararası başağrısı derneğinin 2013 yılı ICHD-3 beta sınıflamasına göre tanı kriterleri ; auralı migren başağrısı tanı kriterlerini karşılaması en az iki atak geçirmesi, geri dönüşümlü motor güçsüzlüğün eşlik etmesi, vizüel, pozitif, duyusal veya konuşma bozukluğunun en az bir tanesinin eşlik etmesi, her bir aura semptomunun 5 dakikadan uzun, 24 saatten kısa sürmesidir. Familyal olgularda en az bir tane, birinci veya ikinci derece aile öyküsü olması şeklindedir.Tek taraflı kol ve bacağında yaklaşık bir gün süren hemiparezi ve afazi yakınmaları olan 44 yaşında kadın hasta ve aynı yakınmaları olan 14 yaşındaki oğlu kliniğimize başvurdu. Öykülerinde güçsüzlüğün eşlik ettiği auralı migren başağrısı olduğu öğrenildi. Nörolojik muayenelerinde bilateral konjuge bakışta hızlı fazı bakış yönünde nistagmus mevcuttu. İki hastanın genç inme etiyolojik tetkikleri normaldi.Migren hastalarında aura semptomu olarak hemipleji görülmesi nadir bir durumdur. Hemiparezi ve afazi nedeni ile başvuran hastalarımızın ayırıcı tanıları eşliğinde familyal hemiplejik migrenin gözden geçirilmesi planlandı.

Keywords

• Familyal Hemiplejik Migren, Genç İnme, Aura

Abstract

According to the 2013 (ICHD-3 beta) Classification of the International Headache Society (IHS), the diagnostic criteria for hemiplegic migraine are: having had at least two attacks meeting the criteria for migraine with aura, in which there were accompanying reversible motor weakness and visual, sensory or speech symptoms; each aura symptom must last no less than 5 minutes and not more than 24 hours. In familial cases, diagnosis is made when at least one first- or second-degree relative has also had attacks fulfilling the above diagnostic criteria. A 44 year old woman presented to our clinic with the complaints of unilateral hemiparesis and aphasia in the arm and leg lasting approximately one day; her 14 year old son also presented with the same complaint. It was discovered that they both had a history of migraine headaches with aura, accompanied by weakness. Their neurological examinations revealed that during bilateral conjugate gaze, nystagmus with the fast phase beating in the direction of gaze was present. For both patients, etiological tests for young stroke were normal. It is rare to see hemiplegia as an aura symptom in migraine patients. It was aimed to review familial hemiplegic migraine along with differential diagnoses of our patients presenting with hemiparesis and aphasia.

Keywords

• Famılıal Hemıplegıc Mıgraıne, Young Stroke, Aura

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