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Familial hemiplegic migraine (FHM) is a rare inherited autosomal dominant diso rder. Migraine aura may last up to several weeks and then resolve without sequel . We report a 21 year old male with FHM since the age of 3 years. Diffusion w eighted magnetic resonance imaging (DWI), perfusion MR imaging (P MRI) and [9 9 mTc] hexamethyl propyleneamine oxime single photon emission tomography (HMPA O SPECT) were performed on day 2, when he was somnolent with right sided hemipl egia, on day 9 when a mild hemiparesis was still present and on day 24 after rec overy. The right central region showed normal findings in DWI, whereas P MRI an d SPECT revealed hyperperfusion on day 2, less marked on day 9, and normal findi ngs on day 24. In conclusion, this case report indicates for the first time, by means of SPECT, P MRI and DWI studies, that even extremely long lasting migrai ne aura is not associated with cerebral ischaemia. Therefore, it supports the re vised International Headache Society criteria where the term persistentaura is proposed.
Familial hemiplegic migraine (FHM) is a rare inherited autosomal dominant diso rder. Migraine aura may last up to several weeks and then resolve without sequel. We report a 21 year old male with FHM since the age of 3 years. Diffusion w eighted magnetic resonance imaging (DWI), perfusion MR imaging (P MRI) and [9 9 mTc] hexamethyl propyleneamine oxime single photon emission tomography (HMPA O SPECT) were performed on day 2, when he was somnolent with right side hemipl egia, on day 9 when The right central region showed normal findings in DWI, while P MRI an d SPECT revealed hyperperfusion on day 2, less marked on day 9, and normal findi ngs on day 24. In conclusion, this case report indicates for the first time, by means of SPECT, P MRI and DWI studies, that even extremely long lasting migrai ne aura is not associated with cerebral ischaemia. Therefore, it supports the re vised International Headache Society criter ia where the term ºpersistent Åaura is proposed.