Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0018991 (hemiplegia)
 3,997 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The authors use the term "complicated migraine" to describe the onset of neurological disorder occurring during an acute attack in a patient with chronic migraine. The disturbance may last for long periods or may be permanent, and these irreversible cerebral lesions have to be differentiated from the transient neurological effects characteristic of ophthalmic on secondary migraine. Patients with migraine and retinal lesions, as well as those with ophthalmoplegic or familial hemiplegic migraine, were excluded from the study. The seven cases reported included 5 women and 2 men with an average age of 30 years (from 14 to 51 years). A more or less severe lesion in a hemisphere was present, which led to sensory-motor signs of a hemiplegia (4 cases), an aphasia (4 cases), and a homonymous lateral hemianopia (3 cases). Exploration revealed the presence of an ischemic cerebral lesion in all cases. One or more arterial occlusions were also noted in 5 out of the 6 patients who were investigated by angiography. All cases showed the presence of the criteria thought to be essential for associating the cerebral ischemic lesion with migraine. 1) the patient had true migraine, 2) there was a close chronological relationship between the migraine attack and the lasting neurological disorder, 3) no other associated vascular disease was present (atheroma, cardiopathy). The very severe and prolonged spasm, which could be the cause of neurological disturbances in secondary and ophthalmic migraine, does not appear to be sufficient for producing an irreversible ischemic lesion and, more especially, a persistent vascular obstruction. The roles played by edema of the arterial wall and parietal changes in the vessels are discussed. It could be that thrombosis formation is encouraged by the changes in blood coagulability which may be associated with a migraine attack. The fact that anomalies in platelet aggregation have been demonstrated merits closer study.
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PMID:[Cerebral ischemic accidents during migraine attacks. A report on "complicated migraine"]. 746 14

By analogy with ophthalmic migraine, hemiplegic migraine is defined by the occurrence during the attacks of unilateral weakness. This simple definition is however far from reflecting the wide range of clinical situations reported under this term. Familial hemiplegic migraine (FHM) is a well individualized autosomal dominant condition. Attacks start in childhood, adolescence, or early adulthood. They invariably include a unilateral weakness lasting 30 to 60 minutes and almost always associated with visual, sensory, or speech disturbances. They are occasionally very severe with a dense hemiplegia, confusion, coma or fever, but they always completely recover. Brain neuroimaging is normal. In 20% of the families, migraine is associated with permanent neurological signs, mainly nystagmus and cerebellar ataxia. FHM is a genetically heterogeneous condition, with half of the families linked to chromosome 19 and the other half in which this link is excluded. By contrast to FHM, which is a well defined entity, other varieties of so called hemiplegic migraine do not deserve to be individualized as such. They include attacks of migraine with typical aura when a unilateral weakness is part of the aura, severe hemiplegic attacks similar to those reported in FHM but sporadic, migrainous infarcts with hemiplegia, and, for some authors, alternating hemiplegia of childhood. The pathogenesis of all these conditions and of migraine itself remaining largely unknown, it is currently impossible to know whether or not they share common pathophysiologic mechanisms. The identification of the gene on chromosome 19 and the discovery of other genes will be major steps to elucidate this question.
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PMID:[Hemiplegic migraine]. 789 22