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Background: Hemiplegic migraine is a rare form of migraine with aura that includes motor weakness. Diagnosis during thefirst episode can be difficult to make and costly, especially with the sporadic form.Cases: Our study evaluates the ictal magnetic resonance imaging (MRI) features of four sequential pediatric patientsduring a first-time, sporadic hemiplegic migraine. Susceptibility-weighted imaging (SWI) revealed cerebral venous prominenceand increased magnetic susceptibility affecting brain regions that corresponded with each patient's neurologicdeficits. Repeat MRI (performed in three patients) following migraine recovery demonstrated resolution of all susceptibilityabnormalities.Conclusion: When combined with conventional MRI sequences, SWI has diagnostic value in the acute setting of motorweakness and with clinical features consistent with hemiplegic migraine. The sequence may help to further characterizeictal cerebral blood flow changes during the hemiplegic migraine aura. [ABSTRACT FROM AUTHOR]

Objective: We analyzed the incidence and demographic features of pediatric intracranial hypertension.Methods: Inpatient and outpatient encounters of children aged 18 years or younger who were diagnosed with primary (idiopathic) or secondary intracranial hypertension between January 2010 and December 2013 were identified. Data were collected from a subspecialty clinic devoted to intracranial hypertension and the sole children's hospital in a large Midwestern city of the United States. Estimated incidence rates were calculated based on the number of newly diagnosed patients in our hospital's primary service area, which includes seven central Ohio counties. Sex, race, body mass index, socioeconomic status, and geographic distribution were also noted.Results: A total of 74 pediatric patients were diagnosed with intracranial hypertension (49 primary/idiopathic and 25 secondary) between January 2010 and December 2013. Using census data, we determined the pediatric population in our service area during the four-year period. The Ohio Hospital Association's database indicated that 92.3% of patients aged 0 to 17 years residing in the region sought care at our institution. By combining these data, we calculated an annual incidence of primary and secondary intracranial hypertension of 0.63 and 0.32 per 100,000 children, respectively.Conclusions: The estimated annual incidence of pediatric primary intracranial hypertension in our seven county service area in central Ohio is similar to previous pediatric reports from other countries and is 67% of that reported in the US adult population. [ABSTRACT FROM AUTHOR]