Cessation of sporadic hemiplegic migraine attacks after patent foramen ovale closure

Abstract

Patent foramen ovale (PFO) may act as a causal or triggering factor for migraine attacks. A recent quantitative systematic review of the relationship between PFO and migraine has revealed that the already existing data which imply increased prevalence of PFO in patients with migraine attacks, increased prevalence of migraine attacks in patients with PFO, and improvement (even total abolition) of migraine attacks, after PFO closure in migraineurs are supported by little evidence. 3,4 The authors of this review, however, state that no conclusion can be drawn about the efficacy of PFO closure in migraine treatment, as further studies are needed. To our knowledge, we report the first case of a 14-yearold male whose SHM attacks disappeared after PFO closure. The 14-year-old male was admitted urgently to the Department of Developmental Neurology, Medical University of Gdansk, with severe headache (most prominent in fronto-temporal region bilaterally) accompanied by nausea and vomiting preceded by visual disturbances, dysarthria, weakness of the left limbs, and facial asymmetry that appeared about an hour before admission. Twelve months earlier he had been diagnosed in our clinic with probable sporadic hemiplegic migraine (the results of paediatric and neurological examination, neuroimaging, laboratory tests, and electroencephalograph were all negative).