Monozygotic twin sisters discordant for familial hemiplegic migraine

Background: The high concordance rate of migraine in monozygotic twin pairs has long been recognised. In the current study, we present a monozygotic twin pair discordant for familial hemiplegic migraine (FHM). Case presentations: We evaluated 12 adult family members in 2012. The twin pair was separately examined by neurologists at different time points. Mutation screening was performed for known FHM-related genes. The monozygosity of the twins was verified. Eleven individuals had a history of migraine or paroxysmal neurological symptoms, including four patients with motor aura. No mutations were detected in the CACNA1A, ATP1A2, SCN1A, PRRT2 or NOTCH3 genes. The monozygotic twin sisters, aged 52, were discordant for age of onset, motor aura and neuropsychological aura (forced thinking). Overall, the family members presented a wide range of phenotypical features. Conclusions: Familial hemiplegic migraine is a monogenic disorder that is distinct from migraine with typical aura. However, in certain families with motor aura, such as this one, it is possible that the most severe phenotype is caused by an unlikely combination of polygenic traits and non-genetic factors. In these kindreds, we propose that hemiplegic aura is only a severe and complex form of typical aura.

Palavras-chave

Hemiplegic migraine Migraine with typical aura Monozygotic twins Forced thinking

URI

http://hdl.handle.net/10400.16/1497

Citação

Barros et al.: Monozygotic twin sisters discordant for familial hemiplegic migraine. The Journal of Headache and Pain 2013 14:77

Editora

Springer open journal

Coleções

SN - Artigos publicados em revistas indexadas na Pubmed/Medline
SNOS - Artigos publicados em revistas indexadas na Medline

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