Migraine is usually not associated with CSF pleocytosis. However, patients with migraine-like severe headache who showed temporary neurological deficits and pleocytosis have recently been accumulated in the literature. Here we report a 20-year-old woman who was admitted to our hospital because of aphasia and right hemiparesis with severe throbbing headache in the left on 15 February, 2001. During the preceding 3 days she experienced another two similar episodes. Lumbar puncure revealed lymphocyte dominant pleocytosis of 56 cells/microliter. These symptoms recovered completely within several hours. EEG showed intermittent theta waves of 4-5c/s, 50-80 microV in the bilateral fronto-parietal region, but no epileptiform activity. On the 12th day 123I-IMP SECT demonstrated rather hyperperfusion in the left fronto-temporo-parietal region. Again, in the early morning on 10 December she was carried to our hospital by an ambulance car because of severe headache, right hemiparesis, expressive and receptive aphasia and drowsiness. Body temperature was 37.9 degrees C and lumbar puncture revealed increased opening pressure of 230 mmH2O and cells of 17/microliter. All the symptoms cleared within 24 hours and she left hospital without any sequelae. The symptoms of this case are consistent with those of headache with neurologic deficits and CSF lymphocytosis (HaNDL) by Berg et al, or pseudomigraine with pleocytosis (PMP syndrome) by Gometz-Aranda et al. No reports have been published on this disease in Japan.
Adult Aphasia