Hemiplegic migraine (HM) is an unusual type of migraine, with few cases reported in the literature. Unlike other types of migraine, aura HM presents accompanying motor deficit manifestations that do not last more than 24 hours. We report a 27-year-old man referred to us from the emergency department to carry out a cerebral perfusion SPECT with (99m)Tc-HMPAO. He presented with intense headache and motor weakness. The brain perfusion scan was performed before and after intravenous infusion with nimodipine and showed a significant change of cerebral blood flow, allowing early and correct diagnosis.

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