Intravenous Nimodipine Treatment for Severe Episode of ATP1A2 Hemiplegic Migraine.

Abstract Hemiplegic migraine (HM) is a rare, genetically heterogenous migraine subtype with aura presenting as recurrent transient attacks of hemicrania and hemiparesis. There are no established evidence-based guidelines for the emergency management of HM, and acute therapy therefore remains empiric. We report for the first time a successful treatment of a prolonged Na+-K+-ATPase subunit gene ATP1A2 -linked HM attack in a pediatric case with the calcium antagonist nimodipine. Nimodipine treatment is currently established only for management of HM involving calcium channels. Our results suggest that nimodipine can be an effective emergency treatment option for HM devoid of calcium channel pathologies, arguing for suggested effects of nimodipine such as the inhibition of cerebral vasoconstriction.