Sporadic Hemiplegic Migraine.

An uncommon presentation of a migraine headache is hemiplegic migraine, which can clinically imitate other conditions including transient ischemic attacks and stroke with unilateral muscle weakness or hemiplegia. We present a 46-year-old female patient who was admitted with symptoms of a unilateral occipital headache, dysphagia and left-sided motor weakness. Diffusion magnetic resonance imaging (MRI) and brain tomography results were normal. A diagnosis of sporadic hemiplegic migraine was made after extensive workup and managed conservatively with solumedrol. The patient was discharged on prednisone and tetrahydrozoline ophthalmic solution with a drastic improvement in symptoms. On a follow-up visit, there was a complete resolution of symptoms.

Unusual Presentation of a Hemiplegic Migraine in a Seven-Year-Old Child: A Case Report.

In the pediatric population, headache is a common presenting symptom, and migraine is often the diagnosis. A hemiplegic migraine is characterized by an aura and sudden-onset weakness on one side of the body that usually resolves without causing any permanent neurological damage. In this case, we present a seven-year-old male child with a known case of proximal tubular dysfunction (homozygous mutation in the SLC4A4 gene) who presented to the emergency department with a one-day history of weakness on the right side of his body. A few hours after being discharged from the hospital, he began complaining of a severe headache on the left side, accompanied by photophobia, phonophobia, and high fever. Radiology scans and laboratory workup were unremarkable, and encephalitis was ruled out. He was later diagnosed with hemiplegic migraine based on his history and clinical presentation.

Transient Hemi-paresthesia after Eating Puffer Fish (Fugu): A Case Report.

The patient was a 64-year-old man who felt numbness of the tongue 30 minutes after eating puffer fish (fugu) prepared by an unqualified person. He then felt hotness on the left side of his face and head, followed by left hemi-paresthesia. The patient had obesity and dyslipidemia. On arrival at our hospital, 150 minutes after eating the fugu, his consciousness was clear, and his only abnormal vital sign was mild hypertension. At approximately four hours after eating the fugu, his hemi-paresthesia spontaneously subsided. He was admitted to our hospital and his post-admission course was uneventful. Brain magnetic resonance image revealed no specific findings. He was discharged on 2nd day of hospitalization without complaint. We presented the 1st case of transient hemi-paresthesia after eating fugu. The mechanism underlying the development of hemi-paresthesia may be pure sensory ischemic attack or fugu intoxication due to an asymmetric distribution of sodium channels.