evaluation of patients with hemiplegic migraine in mackenzie headache clinic

background: the sporadic type of hemiplegic migraine (hm) is sometimes observed among migrainous patients (mp) and mimics ischemic strokes. methods: in an evaluation of two-hundred consecutive adult mp in the mackenzie headache clinic, canada during 2004 , 9% of the patients met the criteria established by the international headache society for sporadic hm. female to male sex ratio, family history of migraine, frequency of epileptic seizures, migraine status and migraine aura without headache were investigated in the hm group and compared with other mp. the relationship between side of hemiplegia and distribution of head pain was also evaluated. results: all of these clinical dimensions were significantly more common in the hm group than in the other mp. all of the patients with hm had other types of aura. hemiplegia was often ipsilateral to the side of the headache. these results highlight the importance of documenting the side of hemiplegia in relation to the headache side, as well as determining the history of seizures in hm patients. conclusion: this study supports the argument that migraine is a disease which may appear with different or mixed presentations in each episode.