Case Reports in Neurology · Published 2026-07-22 · DOI 10.1159/000553486
Amandine Goossens, Ann-Laurence Delabie, Tanguy Demaret, Deniz Karadurmus, Vincenzo Pignato
This case describes a diagnostically challenging presentation of familial hemiplegic migraine, combining prolonged hemiparesis, severe headaches, altered consciousness and fever. Such a constellation initially suggested acute stroke, encephalitis, or status epilepticus. It underscores the wide phenotypic variability of familial hemiplegic migraine and the risk of misdiagnosis in emergency settings. A precise clinical history and targeted genetic testing (CACNA1A, ATP1A2, SCN1A and PRRT2) proved essential for identifying this rare condition. Early recognition enabled appropriate management and avoided unnecessary interventions.
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Goossens, A., Delabie, A., Demaret, T., et al. (2026). Case report When Hemiplegic Migraine Defies Expectations: Diagnostic Complexity in a Rare Genetic Disorder. Case Reports in Neurology. https://doi.org/10.1159/000553486