Continuum Hedache 2006 by Morris Levin et al.

By Morris Levin et al.

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In patients with motor weakness, 47% had a family history of migraine; 18% had a family history of hemiplegic migraine. The average age of onset of hemiplegic migraine may be earlier than that of migraine without aura, while the attacks themselves are frequently precipitated by minor head injury. Changes in consciousness ranging from confusion to coma are a feature, especially in childhood, and occurred in 23% of the series of Bradshaw and Parsons (1965). 01% (Lykke Thomsen et al, 2002). The differential diagnosis of hemiplegic migraine includes focal seizures; stroke; homocystinuria; and myopathy, encephalopathy, lactic acidosis, and strokelike episodes (MELAS) syndrome (Hosking, 1988).

On how many days in the last 3 months did you have a headache? ) _____ days B. On a scale of 0–10, on average how painful were these headaches? ) Grade Definition Score I Minimal or infrequent disability 0–5 II Mild or infrequent disability 6–10 III Moderate disability 11–20 IV Severe disability 21+ Reprinted with permission from Stewart WF, Lipton RB, Whyte MS, et al. An international study to assess reliability of the Migraine Disability Assessment (MIDAS) score. Neurology 1999;53:988–994. Copyright # 1999, AAN Enterprises, Inc.

These recurrent attacks of severe vomiting last 1 to 5 days. KEY POINTS: A DIFFERENTIAL DIAGNOSIS Cerebral Autosomal Dominant Arteriopathy With Subcortical Infarcts and Leukoencephalopathy Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is an inherited arterial disease of the brain that was mapped to chromosome 19 and has since been reported in more than 200 families worldwide. The main clinical feature of CADASIL is recurrent subcortical events, either transient or permanent, that occur at a mean age of 45 years.

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