5-year Progression of CADASIL: A Case Report

Abstract

A female patient in her 40’s of mixed Chinese-Indian ancestry was referred to our neurology clinic for frequent migraine with aura and CADASIL. She had been treated for acute encephalopathy in 2014. The incident led to her CADASIL diagnosis and later retinitis pigmentosa, both rare conditions. Initial clinical assessment showed moderate severity of migraine and normal cognitive function. As there is no specific treatment recommended for CADASIL, the patient was maintained on pharmacological therapies for secondary prevention of ischaemic stroke, treatment of seizure, symptomatic treatment for migraine and a cholesterol-lowering drug. A supplement containing Vitamin E (tocotrienols) was recommended. During the ensuing 5-years, there were no further neurovascular incidents and her migraine went into full remission.