To the Editor.—
Schraeder and Burns (Archives 1980;37:377-379) suggested that the rare CSF lymphocytosis found in patients with hemiplegic migraine results from a secondary meningeal reaction. Another report concluded that the complicated migraines of seven patients resulted from an inflammatory disturbance.1 The following case details the difficulty in distinguishing between aseptic meningitis with secondary migraine and migraine with secondary meningeal reaction.
Report of a Case.—
A 21-year-old, righthanded woman suffered six attacks of transient neurologic deficit and headache without fever in a period of four weeks. In the first attack, she experienced numbness of the right hand that marched to arm, shoulder, and tongue, followed within minutes by mild expressive language difficulty, scintillating scotoma, severe bitemporal throbbing headache, nausea, and emesis. She slept and felt normal the next morning. One day later, she noted numbness of the left arm without speech dysfunction, followed by severe headache that resolved with sleep.
Dobkin BH. Migraine and Meningitis. Arch Neurol. 1981;38(1):69. doi:10.1001/archneur.1981.00510010095032
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