[Pseudomigraine with pleocytosis]

Abstract

We report two cases of male patients aged 32 and 34 presenting with headache, neurological deficits, and fever. Neither the patients nor their families had a history of migraine. Analysis of the CSF revealed lymphocytic pleocytosis, but no causative infectious agent could be identified. During the attacks, EEG showed focal slowing and was normal afterwards. Computed tomography, MRI, Doppler sonography, and routine blood parameters were normal. In both patients, the focal deficits and the headache vanished within a few hours. We diagnosed a pseudomigraine with pleocytosis (PMP), recently described as an entity. This disorder is characterized by brief relapsing attacks with headache, nausea, vomiting, focal neurological deficits, and a lymphocytic pleocytosis in the CSF. The differentiation from vascular disorders is important because angiography should be avoided due to a high rate of complications in patients with PMP.