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

Paterson, R. W. and Uchino, K. and Emsley, Hedley and Pullicino, P. (2013) Recurrent stereotyped episodes in cerebral amyloid angiopathy:response to migraine prophylaxis in two patients. Cerebrovascular Diseases Extra, 3 (1). pp. 81-84. ISSN 1664-5456

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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.

Item Type:
Journal Article
Journal or Publication Title:
Cerebrovascular Diseases Extra
Uncontrolled Keywords:
/dk/atira/pure/subjectarea/asjc/2700/2705
Subjects:
ID Code:
84652
Deposited By:
Deposited On:
09 Feb 2017 09:34
Refereed?:
Yes
Published?:
Published
Last Modified:
06 Aug 2020 04:10