Not All Patients with Hemiplegia Need Alteplase: A Case of Hemiplegic Migraine

Hemiplegic migraine (HM) is a rare type of migraine which presents with motor and sensory impairment like a cerebrovascular accident (CVA). We present a case of a 36-year-old female, with a prior CVA treated with alteplase, who presented to the emergency department with stroke-like symptoms with a d...

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Bibliographic Details
Main Authors: Sumeet Yadav, Michelle Talukder, Jacky Duong
Format: Article
Language:English
Published: SMC MEDIA SRL 2020-04-01
Series:European Journal of Case Reports in Internal Medicine
Subjects:
Online Access:https://www.ejcrim.com/index.php/EJCRIM/article/view/1585
Description
Summary:Hemiplegic migraine (HM) is a rare type of migraine which presents with motor and sensory impairment like a cerebrovascular accident (CVA). We present a case of a 36-year-old female, with a prior CVA treated with alteplase, who presented to the emergency department with stroke-like symptoms with a duration of 1 hour. The NIH Stroke Scale score was 22 at presentation. The patient received alteplase under the supervision of a neurologist after head CT confirmed no bleed. Further work-up revealed no acute or remote ischaemia or infarction. This case demonstrates the importance of a thorough history, intercommunication between health systems and integrated Electronic Medical Records (EMR) for early diagnosis and management of HM.
ISSN:2284-2594