The Spectrum of Imaging Findings in Pediatric Hemiplegic Migraine

D.A. Rigual, N.V. Stence, L.Z. Fenton, S. Kedia, A. Vossough, and D.M. Mirsky

View Article on Neurographics Website

Date of Activity Release: Dec. 1, 2016
Date of Activity Expiration: Dec. 1, 2019

Target Audience:
Intended for neuroradiologists and neuroradiology trainees with varying degrees of experience.

Learning Objectives:
Recognize the spectrum of imaging findings in patients with hemiplegic migraine seen acutely and in those with delayed presentation. Recognize features that distinguish hemiplegic migraine from arterial ischemic stroke and other differential diagnoses.

Hemiplegic migraine is a variant of migraine that includes a component of fully reversible unilateral motor weakness (aura), which typically lasts from 5 minutes to 72 hours. Sporadic hemiplegic migraine is a diagnosis of exclusion because 2 similar episodes are required to make the diagnosis. Diagnosis can be challenging because symptoms mimic arterial ischemic stroke and other entities. Atypical cases may have severe protracted symptoms, and, in children, a history may be elusive. Awareness of neuroimaging findings associated with hemiplegic migraine is important to distinguish from processes with similar clinical presentations associated with irreversible deficits. By using a multi-institutional series of children and adolescents supported by an extensive literature review, we provided a pictorial essay of the spectrum of imaging findings of hemiplegic migraine in the pediatric population.

Commercial Support
No commercial support was received for this activity.

Credit Designation Statement

The American Society of Neuroradiology is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

The American Society of Neuroradiology designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 Credit(s)TM. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Method of Physician Participation:
Each participant will review the corresponding Neurographics article located at Upon completion, each physician will complete and pass a post-test with a score of at least 80% to receive a CME certificate.

All individuals in control of content have disclosed the following relevant financial relationships. All of these relationships were treated as a conflict of interest, and have been resolved (C7 SCS 6.1-6.2, 6.5)

Authors have no relevant financial relationships.





Barton Branstetter 

Editor in Chief

None, N/A

Adam Flanders

Deputy Editor

Royalties, Lippincott Williams and Wilkins

Robert Quencer 

Consulting Editor

None, N/A

Mark Mullins

Associate Editor

Non-remunerative position, AUR6

Meng Law

Associate Editor

Stockholder, Clinical Imaging

Michele Johnson

Associate Editor

Consultant, Boston Scientific, Inc.

Edward Escott

Associate Editor

Grant, Atherysys, Inc.; Royalties, Thieme Medical Publishers

Scott Faro

Associate Editor

None, N/A

Tina Young Poussaint

Associate Editor

None, N/A

Dheeraj Ghandi

Associate Editor

Grant, Arstasis, Axera Inc.; Consultant, Covidien, EV3

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