en جراحی اعصاب Neurosurgery گزارش مورد Case Report <div style="text-align: justify;"><span style="line-height:2;"><span style="font-size:12px;"><span style="font-family:Tahoma;">Familial hemiplegic migraine (FHM) is a rare autosomal dominant subtype of migraine with aura that may present with acute focal neurological deficits in children, closely resembling serious intracranial pathologies such as brain tumors or vascular malformations. We report a previously healthy 9-year-old boy who presented with acute-onset frontal headache followed by progressive left-sided hemiparesis and paresthesia. Initial brain computed tomography raised concern for a possible brain mass, although no vasogenic edema or mass effect was reported. Subsequent brain magnetic resonance imaging (MRI) showed no structural abnormalities, with mild asymmetry of the lateral ventricles interpreted as a normal anatomical variant. Notably, there was no evidence of a space-occupying lesion, ischemia, or parenchymal abnormality. The patient&rsquo;s neurological deficits completely resolved within 48 h with supportive care. A positive maternal history of similar episodes prompted genetic testing, which confirmed a pathogenic variant in the ATP1A2 gene (consistent with familial hemiplegic migraine type 2 (FHM2)), establishing the diagnosis of familial hemiplegic migraine. Familial hemiplegic migraine should be considered in the differential diagnosis of acute hemiparesis in children. Early recognition can prevent unnecessary invasive investigations and guide appropriate management and family counseling.</span></span></span></div> Brain Diseases, Case report, Familial hemiplegic Migraine, Hemiparesis, Pediatric 0 0 http://jsurgery.bums.ac.ir/browse.php?a_code=A-10-472-3&slc_lang=en&sid=1 Ayla Mosanen a.mosanen@arums.ac.ir 0009-0000-8449-9272 No Department of Pediatric Neurology, Ardabil University of Medical Sciences, Ardabil, Iran Narges Falsafi n.falsafi@arums.ac.ir 0009-0001-3592-8605 Yes Department of Pediatric Nephrology, Ardabil University of Medical Sciences, Ardabil, Iran