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Status migrainosus as an initial presentation of multiple sclerosis
BACKGROUND: Demyelinating plaques may induce headache through disruption of the pathways, which are implicated in the pathogeneses of migraine. We report a case of 25-year-old female patient, who presented with status migrainosus fulfilling the criteria of international classification of headache di...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer International Publishing
2015
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4308583/ https://www.ncbi.nlm.nih.gov/pubmed/25646151 http://dx.doi.org/10.1186/s40064-015-0818-9 |
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author | Alroughani, Raed Ahmed, Samar F Khan, Riyadh Al-Hashel, Jasem |
author_facet | Alroughani, Raed Ahmed, Samar F Khan, Riyadh Al-Hashel, Jasem |
author_sort | Alroughani, Raed |
collection | PubMed |
description | BACKGROUND: Demyelinating plaques may induce headache through disruption of the pathways, which are implicated in the pathogeneses of migraine. We report a case of 25-year-old female patient, who presented with status migrainosus fulfilling the criteria of international classification of headache disorder. She was eventually diagnosed with multiple sclerosis (MS) after an extensive work-up and long-term clinical and radiological follow-up. FINDINGS: At the onset of status migrainosus, magnetic resonance imaging (MRI) revealed the presence of several demyelinating lesions fulfilling Swanton criteria. She was started on migraine prophylactic treatment but there was no subsequent response. One year later, she presented with recurrent status migrainosus and a follow-up MRI revealed multiple gadolinium-enhancing lesions in the brain. She was treated with abortive migraine medications. Within the following 2 year, she developed ascending parasthesia and weakness of both lower limbs indicative of incomplete transverse myelitis in association with recurrent status migrainosus. A diagnosis of MS was established based on a follow-up MRI that satisfied the revised 2010 McDonald criteria. Both the headache and neurological signs improved with IV methylprednisolone therapy. Her headache entered remission after initiation of a disease modifying therapy. CONCLUSION: Status migrainosus can be the initial presentation of MS. Unresponsiveness to migraine prophylactic therapy in the presence of active demyelinating plaque in MRI brain may pose a diagnostic challenge and a diagnosis of MS might be considered. |
format | Online Article Text |
id | pubmed-4308583 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2015 |
publisher | Springer International Publishing |
record_format | MEDLINE/PubMed |
spelling | pubmed-43085832015-02-02 Status migrainosus as an initial presentation of multiple sclerosis Alroughani, Raed Ahmed, Samar F Khan, Riyadh Al-Hashel, Jasem Springerplus Short Report BACKGROUND: Demyelinating plaques may induce headache through disruption of the pathways, which are implicated in the pathogeneses of migraine. We report a case of 25-year-old female patient, who presented with status migrainosus fulfilling the criteria of international classification of headache disorder. She was eventually diagnosed with multiple sclerosis (MS) after an extensive work-up and long-term clinical and radiological follow-up. FINDINGS: At the onset of status migrainosus, magnetic resonance imaging (MRI) revealed the presence of several demyelinating lesions fulfilling Swanton criteria. She was started on migraine prophylactic treatment but there was no subsequent response. One year later, she presented with recurrent status migrainosus and a follow-up MRI revealed multiple gadolinium-enhancing lesions in the brain. She was treated with abortive migraine medications. Within the following 2 year, she developed ascending parasthesia and weakness of both lower limbs indicative of incomplete transverse myelitis in association with recurrent status migrainosus. A diagnosis of MS was established based on a follow-up MRI that satisfied the revised 2010 McDonald criteria. Both the headache and neurological signs improved with IV methylprednisolone therapy. Her headache entered remission after initiation of a disease modifying therapy. CONCLUSION: Status migrainosus can be the initial presentation of MS. Unresponsiveness to migraine prophylactic therapy in the presence of active demyelinating plaque in MRI brain may pose a diagnostic challenge and a diagnosis of MS might be considered. Springer International Publishing 2015-01-23 /pmc/articles/PMC4308583/ /pubmed/25646151 http://dx.doi.org/10.1186/s40064-015-0818-9 Text en © Alroughani et al.; licensee Springer. 2015 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. |
spellingShingle | Short Report Alroughani, Raed Ahmed, Samar F Khan, Riyadh Al-Hashel, Jasem Status migrainosus as an initial presentation of multiple sclerosis |
title | Status migrainosus as an initial presentation of multiple sclerosis |
title_full | Status migrainosus as an initial presentation of multiple sclerosis |
title_fullStr | Status migrainosus as an initial presentation of multiple sclerosis |
title_full_unstemmed | Status migrainosus as an initial presentation of multiple sclerosis |
title_short | Status migrainosus as an initial presentation of multiple sclerosis |
title_sort | status migrainosus as an initial presentation of multiple sclerosis |
topic | Short Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4308583/ https://www.ncbi.nlm.nih.gov/pubmed/25646151 http://dx.doi.org/10.1186/s40064-015-0818-9 |
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