Introduction: EEG is not a standard examination for diagnosis of migraine. Nevertheless, it is useful for making a differential diagnosis with seizures. Different types of electroen-cephalographic abnormalities have been reported during hemi-plegic migraine attacks. Case Report/Case History: A 24 year-old man was referred to hospital with multiple episodes of impaired responsiveness and right arm weakness since the age 15 years. He was initially diagnosed with epilepsy and treated with carbamaze-pine 800/d without improvement. Medical history revealed episodes of numbness and paresis starting in the right hand and gradually spreading up into the arm and face, accompanied with aphasia and drowsiness. Symptoms lasted 40 to 90 minute and were followed by a severe, throbbing left-sided headache with photo- and phonophobia, nausea and vomiting. These symptoms resolved completely between attakcs. To the date of first evaluation the patient had experienced 11 stereotypic episodes. MRI and angioMRI performed between episodes were normal. Scalp EEG obtained during his stereotypic attack revealed slowing over the left hemisphere, follow-up EEG was normal . Hemipelgic migraine was diagnosed and carbamazepine was withdrawn. Four years later he experienced the episode of the paresis of the left arm and hemiface followed by a right-sided headache. EEG performer during that episode showed slowing over the right hemisphere which resolved within one week. Conclusion: To the best of our knowledge, this is a first report of EEG taken during left- and right-sided hemiplegic episodes. We documented that an EEG pattern of unilateral slowing, contralateral to the affected body side, characterizes acute episodes with complete resolution of abnormalities in an asymptomatic state. Slowing during the acute episode may reflect depression of cortical reactivity or vasoconstriction and normal follow-up EEG the resolution of cortical changes.
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