Treatment of sporadic hemiplegic migraine with calcium-channel blocker verapamil

Yu, Wengui; Horowitz, Steven H.

doi:10.1212/01.wnl.0000042051.16284.70

Cited by 54 publications

(41 citation statements)

References 16 publications

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“…Perhaps more so than in other forms of migraine, it is imperative to approach SHM as a diagnosis of exclusion, in that the other diagnostic possibilities usually are more sinister and the benefit of a family history, which is so helpful in diagnosing FHM, is lacking. This also is important because many patients with SHM frequently are misdiagnosed for years as having epilepsy, transient ischemic attacks, or even conversion disorder [25]. This leads to inappropriate testing and therapies that are not always benign.…”

Section: Diagnostic Considerationsmentioning

confidence: 99%

“…Most reports suggest starting at 120 mg once or twice daily. Four patients were administered 120 mg of verapamil orally from once daily to three times daily and each experienced a significant reduction, if not complete resolution, of attacks usually within the first month of treatment [25]. One patient received 5 mg of intravenous verapamil over 5 minutes while on telemetry, with resolution of all of the symptoms in just minutes.…”

Section: Preventative Agentsmentioning

confidence: 99%

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Sporadic hemiplegic migraine

Black

2004

Current Science Inc

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Hemiplegic migraine may be familial or sporadic. Both forms share a similar spectrum of clinical presentations and genetic heterogeneity. Current data support the concept that sporadic and familial cases should be thought of as similar, but separate disorders. Sporadic cases are more difficult to diagnose and often require several investigations to rule out more ominous possibilities. Therapeutic options are limited, but future genetic research may elucidate pathophysiologic mechanisms that may, in turn, yield more specific treatments.

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Section: Diagnostic Considerationsmentioning

confidence: 99%

Section: Preventative Agentsmentioning

confidence: 99%

Sporadic hemiplegic migraine

Black

2004

Current Science Inc

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“…16 Flunarizine is widely used in the United Kingdom and particularly effective in children with hemiplegic migraine. 35 Verapamil may also be effective for hemiplegic migraine, 34,36 lamotrigine for aura in general, and divalproex for persistent aura. 34,37 One open-label study with ketamine suggests that the development of suitable agents with actions at excitatory glutamate receptors may be one way forward.…”

mentioning

confidence: 99%

“…8 In case reports, IV verapamil seems effective for acute hemiplegic migraine. 36 Triptans are contraindicated in hemiplegic migraine because it was wrongly considered when they were developed that vasospasm was an important part of migraine aura, and there are thus insufficient systematic data upon which to base any other recommendation.…”

mentioning

confidence: 99%

Child Neurology: Migraine with aura in children

Gelfand¹,

Fullerton²,

Goadsby³

2010

Neurology

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The differential diagnosis for an acute hemiparesis in a child includes stroke, Todd paralysis, and hemiplegic migraine. In the context of an illustrative case, this review highlights the differences in clinical presentation among these entities and an approach to the diagnostic workup. Migraine with aura in children is reviewed, including migraine equivalents such as abdominal migraine and the particular presentation of hemiplegic migraine. An approach to the prophylactic and acute treatment for children with migraine with aura is offered. Neurology ® 2010;75:e16 -e19 CASE: PART 1 A 14-year-old boy with Crohn disease was admitted for a presumed flare. On the second hospital day, his abdominal pain acutely increased. Shortly thereafter, he experienced tingling starting in his shoulder and spreading over his left hemibody over 10 seconds. This was accompanied by 7/10 pounding left-sided head pain. Several minutes later, the tingling gave way to diminished sensation and weakness on the left. These symptoms persisted into the next morning, at which time a neurologic consultation was requested. Now 20 hours into the attack, he had 5/10 pounding head pain. Neurologic examination revealed a left hemiparesis in a pyramidal distribution, with face and arm affected more than leg. Sensation was also diminished over the left face and hemibody. Reflexes were normal and there was no neglect. Complete blood count, electrolytes, erythrocyte sedimentation rate, liver function tests, lactate, amylase, and lipase were normal.

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“…104 It has cerebral vasodilatory properties and may potentially prevent ischemic cell damage. Verapamil may be beneficial in decreasing the frequency and severity of migraine attacks, but any role in underlying disease management is uncertain.…”

Section: Treatmentmentioning

confidence: 99%

Migraine and Cerebral White Matter Lesions

Gladstone

Dodick

2005

The Neurologist

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While the prevalence of nonspecific white matter lesions in migraineurs is increased, the white matter lesions may occasionally represent a secondary cause for headache such as CADASIL. Greater awareness of the unique clinical, neuroimaging, and pathologic features, as well as the availability of diagnostic genetic testing, should enhance the recognition and diagnosis of this fascinating condition.

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Treatment of sporadic hemiplegic migraine with calcium-channel blocker verapamil

Cited by 54 publications

References 16 publications

Sporadic hemiplegic migraine

Sporadic hemiplegic migraine

Child Neurology: Migraine with aura in children

Migraine and Cerebral White Matter Lesions

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