Recurrent Stereotyped Episodes in Cerebral Amyloid Angiopathy: Response to Migraine Prophylaxis in Two Patients
A 70-year-old woman presented with 18 months of stereotyped episodes of altered sensation in the right or left side. Paresthesia spread slowly within minutes to involve contiguous body parts. Attacks involved the face, arm, leg and tongue, lasted 30 min and occurred up to 3 times per week. EEG demonstrated bilateral frequent irregular slow wave activity with sharp components. MRI performed 18 months after symptom onset showed a small (1.3 cm) intraparenchymal hemorrhage in the right parietal lobe. GRE showed decreased superficial cortical signals probably due to hemosiderin deposition, and numerous dark foci suggestive of microhemorrhages predominantly in cortico-subcortical distribution. The attacks increased in frequency and severity after aspirin and dipyridamole were commenced as a treatment for presumed transient ischemic attack (TIA). When antiplatelets were discontinued, the attacks terminated within weeks. This case has previously been published [].\nClinical summaries of all 4 cases are given in table .