Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2013 May 18;3(1):81-4.
doi: 10.1159/000347114. Print 2013 Jan.

Recurrent stereotyped episodes in cerebral amyloid angiopathy: response to migraine prophylaxis in two patients

R W Paterson  1 , K Uchino, H C Emsley, P Pullicino
Affiliations

Recurrent stereotyped episodes in cerebral amyloid angiopathy: response to migraine prophylaxis in two patients

R W Paterson et al. Cerebrovasc Dis Extra. .

Abstract

Background: Cerebral amyloid angiopathy (CAA) typically presents with cognitive decline or symptomatic intracerebral hemorrhage, but episodes of recurrent stereotyped limb attacks have also been reported.

Methods: Retrospective review of the medical records of 4 patients referred to the general neurology services and a specialist stroke center with clinically probable CAA.

Results: Four subjects, all Caucasian, mean age 74 years, were followed up over a mean duration of 20 months. They all experienced recurrent prolonged stereotyped attacks of sensory symptoms, lasting 5-30 min, that resolved completely between attacks. Three subjects developed intracerebral hemorrhage, and 2 had an irreversible rapid cognitive decline. Two patients experienced symptomatic improvement with migraine prophylaxis (verapamil or topiramate).

Conclusions: Recurrent stereotyped prolonged attacks with sensory and motor elements can predate the development of intracerebral hemorrhage in individuals with clinically probable CAA. When evaluating patients with such attacks, neurologists need to consider CAA as a possible mimic of transient ischemic attacks. We suggest a trial of migraine prophylaxis for symptomatic management.

Keywords: Cerebral amyloid angiopathy; Migraine prophylaxis; Recurrent stereotyped episodes.

PubMed Disclaimer

Comment in

References

    1. Izenberg A, Aviv RI, Demaerschalk BM, Dodick DW, Hopyan J, Black SE, Gladstone DJ. Crescendo transient Aura attacks: a transient ischemic attack mimic caused by focal subarachnoid hemorrhage. Stroke. 2009;40:3725–3729. - PubMed
    1. Greenberg SM, Vonsattel JP, Stakes JW, Gruber M, Finklestein SP. The clinical spectrum of cerebral amyloid angiopathy: presentations without lobar hemorrhage. Neurology. 1993;43:2073–2079. - PubMed
    1. Emsley HCA, Kowalewska Zietek J, Gulati RS, Wuppalapati S. When stopping the antiplatelet drugs stopped the ‘TIAs’. Pract Neurol. 2012;12:36–39. - PubMed
    1. Knudsen KA, Rosand J, Karluk D, Greenberg SM. Clinical diagnosis of cerebral amyloid angiopathy: validation of the Boston criteria. Neurology. 2001;56:537–539. - PubMed
    1. Oh U, Gupta R, Krakauer JW, Khandji AG, Chin SS, Elkind MS. Reversible leukoencephalopathy associated with cerebral amyloid angiopathy. Neurology. 2004;62:494–497. - PubMed

LinkOut - more resources