PO-25 | Antiepileptic medication in PRRT2 familial hemiplegic migraine: a case report
Abstract
Background: Antiepileptic medications (AEMs) are known to reduce cortical excitability and have demonstrated efficacy in decreasing the frequency of migraines, particularly in cases of chronic migraine and migraine with aura. Hemiplegic migraine represents a distinct subtype characterized by transient hemiparesis during aura episodes. Familial hemiplegic migraine (FHM) is an autosomal dominant disorder associated with genetic mutations linked to mutations in the genes CACNA1A, ATP1A2, and SCN1A. More recently, mutations in PRRT2 have also been implicated. Aim of the study is the description of the long-term efficacy of AEMs in a PRRT2 case.
Methods: We conducted a retrospective analysis of a 31-year-old man with a lifelong history of migraine from early childhood, who later developed progressive sensory-motor hemiparesis.
Results: Firstly, the patient suffered from migraine without aura but at 15 y.o. he started having initially right-sided hemiparesis which later evolved in a transient ipsilateral sensorimotor hemiparesis which became persistent at 27, with a deficit lasting several months. The patient underwent EEG and neuroimaging with no abnormal results. A heterozygous deletion of the entire PRRT2 gene was identified with Multiplex ligation-dependent probe amplification, the same result was found in two close relatives (sister and mother), whom exhibited similar clinical features. Lamotrigine was the first AEMs choice but after few months he developed suicidal ideation…
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Evidence Hub reads this as a case report, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health.
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