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November 1991

Late-Life Migraine

Author Affiliations

From the Department of Neurology, University of Cincinnati (Ohio) College of Medicine.

Arch Neurol. 1991;48(11):1174-1177. doi:10.1001/archneur.1991.00530230082027

Early in the evening of April 25,1990, a physician, 2 months shy of his 86th birthday, suffered a short dysphasic episode. The expressive aspect of speech apparently was more at fault, although reception also malfunctioned. His wife, realizing something was amiss, asked whether she might call his physician. He indicated not. Reclining briefly (a few minutes), he then arose and walked about, all the while "wriggling" his fingers, testing their function.

There was the slightest cool sensation at the hairline of the left side of the forehead, which soon remitted. The entire episode lasted for a little less than an hour. He then took only a meager dinner rather than the usual repast.

The next day, his relating these symptoms to physician associates occasioned a plethora of examinations, including, among others, blood pressure measurements, an electrocardiogram, chest films, ultrasound examination of carotid arteries in the neck, echocardiogram, and innumerable blood