A young man presenting with acute encephalopathy, hemiparesis, and headache

Tzu Hsuan Weng, Wen Ta Chiu, Marc Afilalo, Cheuk Sing Choy, Chris Tselios, Ping Keung Yip, Carlos Lam

研究成果: 雜誌貢獻文章

2 引文 (Scopus)

摘要

Background: Familial hemiplegic migraine (FHM) is a rare type of migraine. Correct diagnosis is challenging for emergency physicians (EPs) due to its variable clinical picture, as well as its lack of diagnostic biological markers. Objectives: To raise awareness among EPs regarding FHM's diverse clinical picture, and to highlight FHM's diagnostic criteria to facilitate an accurate and timely diagnosis of FHM in patients presenting to the emergency department (ED) with indicative symptomatology. Case Report: A 24-year-old male student presented to the ED complaining of dizziness, general weakness, and blurred vision that had developed the previous night. The initial physical examination revealed drowsiness, slow speech production, and slight weakness with paresthesia in all limbs. Detailed communication with the patient's aunt revealed that he had experienced several similar attacks since the age of 12 years, and that there was also an extensive family history of the same symptoms. In addition, 2 h after arrival, the patient experienced severe throbbing headache, vomiting, severe dysphasia, and the weakness shifted to the right side. A computed tomography scan of the brain showed no anomalies. He was admitted with a tentative diagnosis of FHM. Conclusion: A diagnosis of FHM should be considered if the patient's clinical features include headache and weakness, with a family history of similar symptomatology. However, atypical symptoms of FHM may present as recurrent episodes of unexplained encephalopathy. Crucial elements for making an accurate and timely diagnosis of FHM include a detailed knowledge of weakness-related diseases and an ability to consider FHM in the differential diagnosis, as well as obtaining a thorough family history with repeated neurologic assessments.
原文英語
頁(從 - 到)258-262
頁數5
期刊Journal of Emergency Medicine
43
發行號2
DOIs
出版狀態已發佈 - 八月 2012

指紋

Migraine with Aura
Brain Diseases
Paresis
Headache
Hospital Emergency Service
Emergencies
Physicians
Aptitude
Paresthesia
Sleep Stages
Aphasia
Dizziness
Migraine Disorders
Nervous System
Physical Examination
Vomiting
Differential Diagnosis
Extremities
Biomarkers
Communication

ASJC Scopus subject areas

  • Emergency Medicine

引用此文

A young man presenting with acute encephalopathy, hemiparesis, and headache. / Weng, Tzu Hsuan; Chiu, Wen Ta; Afilalo, Marc; Choy, Cheuk Sing; Tselios, Chris; Yip, Ping Keung; Lam, Carlos.

於: Journal of Emergency Medicine, 卷 43, 編號 2, 08.2012, p. 258-262.

研究成果: 雜誌貢獻文章

Weng, Tzu Hsuan ; Chiu, Wen Ta ; Afilalo, Marc ; Choy, Cheuk Sing ; Tselios, Chris ; Yip, Ping Keung ; Lam, Carlos. / A young man presenting with acute encephalopathy, hemiparesis, and headache. 於: Journal of Emergency Medicine. 2012 ; 卷 43, 編號 2. 頁 258-262.
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abstract = "Background: Familial hemiplegic migraine (FHM) is a rare type of migraine. Correct diagnosis is challenging for emergency physicians (EPs) due to its variable clinical picture, as well as its lack of diagnostic biological markers. Objectives: To raise awareness among EPs regarding FHM's diverse clinical picture, and to highlight FHM's diagnostic criteria to facilitate an accurate and timely diagnosis of FHM in patients presenting to the emergency department (ED) with indicative symptomatology. Case Report: A 24-year-old male student presented to the ED complaining of dizziness, general weakness, and blurred vision that had developed the previous night. The initial physical examination revealed drowsiness, slow speech production, and slight weakness with paresthesia in all limbs. Detailed communication with the patient's aunt revealed that he had experienced several similar attacks since the age of 12 years, and that there was also an extensive family history of the same symptoms. In addition, 2 h after arrival, the patient experienced severe throbbing headache, vomiting, severe dysphasia, and the weakness shifted to the right side. A computed tomography scan of the brain showed no anomalies. He was admitted with a tentative diagnosis of FHM. Conclusion: A diagnosis of FHM should be considered if the patient's clinical features include headache and weakness, with a family history of similar symptomatology. However, atypical symptoms of FHM may present as recurrent episodes of unexplained encephalopathy. Crucial elements for making an accurate and timely diagnosis of FHM include a detailed knowledge of weakness-related diseases and an ability to consider FHM in the differential diagnosis, as well as obtaining a thorough family history with repeated neurologic assessments.",
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AU - Lam, Carlos

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