Right-sided Weakness, Headache in a Young Girl

Poll

VIDEO: A 12 y/o girl reports 5 episodes (45 mins each) of headache, hemiplegia in the past 24 hours. Can you make the Dx?

 

A 12-year-old girl presents with 24-h history of 5 episodes of headache, right sided weakness w/ discomfort that lasted up to 45 minutes. Neurologic abnormalities resolved between episodes. Exam: 1/5 muscle strength in right arm/leg; unstable when standing with eyes closed. Denies tobacco, other drug use. HR, 80 bpm; BP, 120/65. She is otherwise well.

 

What diagnosis do you suspect?

A. Hemiplegic migraines
B. Stroke (CVA)
C. CNS mass
D. Moyamoya disease
E. Conversion disorder (diagnosis of exclusion)
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