New MRI Finding in Migraineurs: Mesial Temporal Sclerosis

Background: Based on our experience, a noticeable number of migraineurs without history of epilepsy disclose mesial temporal sclerosis (MTS) on their brain MRI. Objective: This prospective study was conducted to assess the frequency of MTS in migraineurs and also determine the ratio of unilateral and bilateral cases. Material and Methods: In this cross sectional study, the frequency of MTS in MRI of ۸۴ migraine patients, who had symptoms for at least ۲ years, assessed. Brain MRI was done with T۱ and T۲ weighted protocols. Two radiologists separately interpreted findings, defining MTS as presence of any of hippocampal atrophy, increased T۲ signal of hippocampus, decreased T۱ signal of hippocampus or loss of internal architecture. Patients who radiologists had not agreement on their diagnoses excluded. Stat analysis done using ‘N - ۱’ chi squared test. Results: Eleven patients were excluded due to non-accordant interpretation of MRI findings by the two examining radiologists. MTS was detected in ۱۴ out of ۷۳ patients (۱۹%). Bilateral involvement of mesial temporal lobe was seen in ۶ (۸%) patients (M: ۶۷%, F: ۳۳%). Five cases (۷%) had unilateral left MTS (M: ۶۷%, F: ۳۳%) while ۳ (۴%) were affected with right-sided MTS (M: ۳۳%, F: ۶۷%). These findings highly suggest association of MTS and Migraine (P-value <۰.۰۰۰۱). Conclusion: While MTS is a prevalent finding in migraineurs, incidental finding of MTS in MRI should suspect physicians of migraine as well as temporal lobe epilepsy. MTS can be proposed as an etiology of migraine but most likely, consequence of it.

کلیدواژه ها:

Hippocampal Sclerosis ، Migraine Disorders ، Magnetic Resonance Imaging ، Epilepsy ، Temporal Lobe