Abstract

Background
Patients with migraine may experience symptoms of weakness. These patients often had extensive evaluations and sometimes were labeled as having a psychiatric cause for their weakness. We hypothesized that subjects with unilateral weakness most often do not have psychiatric cause and that their weakness is related to the presence of cutaneous allodynia. Methods: Patients visited to the outpatient clinic for intractable headache were entered into study. Their symptoms during their attacks of weakness were reviewed. Sensory testing was preformed by brush allodynia testing. Giveway weakness was defined as a sudden loss of resistance during strength testing. Results: Ten of 38 patients reported having had unilateral weakness and headache. Five of these patients had unilateral giveway weakness. Mean age of these subjects was 41.2 years old, and all were women. Four had unilateral headache ipsilateral to the weakness and one had bilateral headache. All of these had brush allodynia. Three had blurry vision(ipsilateral to the headache in all, none typical scintillating scotoma). All subjects with unilateral motor or sensory symptoms had typical features of migraine; most were transformed migraine. All subjects had one or more normal neuroimaging studies and most had multiple studies. Conclusions: Severe migraine headache may be associated with unilateral sensory motor symptoms. There need more clinical data to understand the nature of migraine with unilateral motor and sensory symptoms. Korean Journal of Headache 5(2):125-128, 2004