Psychotic aura symptoms in familial hemiplegic migraine type 2 (ATP1A2)

J Headache Pain. 2012 Oct;13(7):581-5. doi: 10.1007/s10194-012-0462-5. Epub 2012 Jun 5.


Introduction: Neuropsychological symptoms are rare in familial hemiplegic migraine (FHM). There are no reports of psychotic symptoms in FHM type 2 (ATP1A2). We examined a family with a FHM phenotype due to a M731T mutation in ATP1A2. A 10-year follow-up allowed us to observe complex auras, including psychotic symptoms in two siblings.

Case report: Male, 48 years old, with an aura that included complex illusions with a feeling of time travelling, coincident with other aura features. The aura was regarded as mystical by the patient. Female, 38 years old, with a complex migraine aura, during which she believed she had the ability to time travel and was being followed by lobbyists who wanted to steal this ability from her.

Discussion: FHM type 2 must be included in the list of differential diagnoses of acute psychosis in patients with a previous history of migraine aura.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Adult
  • Child
  • Epilepsy
  • Female
  • Humans
  • Male
  • Middle Aged
  • Migraine with Aura / complications*
  • Migraine with Aura / genetics
  • Mutation
  • Pedigree
  • Psychotic Disorders / diagnosis*
  • Psychotic Disorders / etiology
  • Psychotic Disorders / genetics
  • Sodium-Potassium-Exchanging ATPase / genetics*
  • Young Adult


  • ATP1A2 protein, human
  • Sodium-Potassium-Exchanging ATPase

Supplementary concepts

  • Hemiplegic migraine, familial type 2