The diagnostic role for susceptibility-weighted MRI during sporadic hemiplegic migraine.

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]