A clinician's dilemma: Sturge-Weber syndrome ‘without facial nevus’!!
A 23-year-old woman with normal birth and developmental history presented with recurrent right hemicranial throbbing headache with photophobia and phonophobia lasting 3-4 hours, relieved by vomiting and sleep, aggravated by travel and sleep deprivation since 21 years of age. She used to have a visual aura of flashes of light preceding the headache. The frequency of headache was 1–2/month. She had one episode of suspected transient loss of vision during one of the episode, so she underwent MRI head, which showed right occipital gyriform calcification typical of SWS. EEG was normal. She had left homonymous hemianopia without any neurocutaneous markers. She was initiated on flunarazine on which she had good control of her migraine at 6 year follow-up.