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Título

Migraine with brainstem aura with recurrent somnolence resembling with the Kleine Levin Syndrome. Case report and review.

Introdução

Basilar migraine, now known as migraine with brainstem aura, is a migraine accompanied by two or more symptoms of aura indicating clear signs of brainstem dysfunction, including: dysarthria, vertigo, tinnitus, hearing loss, ataxia, diplopia, and decreased consciousness. We describe an interesting case of a young woman of indigenous origin admitted to our service who presented with MBA with recurring somnolence resembling Kleine-Levin syndrome. She was successfully treated with corticoid and topiramate

Objetivo

In this manuscript, we report an interesting case of a young woman of indigenous origin admitted to our service who presented with MBA with recurrent somnolence, who was successfully treated with corticoid and topiramate

Métodos

In this manuscript, we report an interesting case of a young woman of indigenous origin admitted to our service who presented with MBA with recurrent somnolence, who was successfully treated with corticoid and topiramate

Resultados

Patient MVPV, female 33 years old. Patient’s relatives reported that on 04/28/2016 the patient presented during the night a headache with a strong intensity of frontal and pulsatile location, with nausea without vomiting. She made use of 1g of dipyrone with caffeine for this pain and went to sleep. Early in the morning, relatives reported that she did not wake up. After 12 hours in this state, relatives tried to wake up a few times during the day, but the patient had a great deal of difficulty opening her eyes and obeying the commands spoke with disjointed words and returning to the previous state. She stayed more than 12 hours with this picture when they decided to take her to the emergency room on 04/29/2016, after almost 48 hours.The patient had PA 80x60, afebrile, normal heart rhythm, HR 100, SAT 96%, with capillary glycemia 100md/dl. She was discharged from hospital after all imaging and laboratory tests including CSF were normal. After that she presented two other similar episodes and was hospitalized again. The hypothesis of Basilar migraine was made and started treatment with predinisone and topiramate successfully.

Conclusões

MBA with somnolence is an unusual entity and has never been described in patients with indigenous origin. Besides, the MBA should be remembered especially in young patients who have a history of past migraine and sometimes can mimic the KLS manifestation.

Palavras-chave

Migraine; Disorder of excessive Somnolence; Kleine-Levin Syndrome.

Área

Relato de Caso

Instituições

Universidade Estadual do Amazonas - Amazonas - Brasil

Autores

Carlos Mauricio Oliveira de Almeida, Ronaldo Marques Pontes Rabelo, Felipe Queiroz Portela, Mariza Marques de Oliveira, Marcus Vinicius Gomes Rodrigues, Marcus Vinicius Della Coletta, Nise Alessandra Carvalho Sousa