Livedo Reticularis as a clue to Diagnosis of Recurrent Stroke and Epilepsy

Introduction: Homocysteimemia has been associated with increased risk forcerebralvasuclar disease and recurrent stroke. Homocysteinmia has primaryatherogenic and prothrombotic properties. It can lead to both venous and arterialthrombosis by several mechanisms. We present a 45 years old female patient withhyperhomocysteinemia and past medical history of epilepsy, two strokes like attacks,livedo reticularis and a new ischemic stroke. Risk factors such as hypertension,diabetes, ischemic heart disease and hyperlipidemia were all absent.Hypercoagulation and vasculities tests were normal. Livedoretiularis was the clue inthis patient that led us to consider homocysteinemia as the most probable diagnosis.This suggests that considering skin lesions in juvenile stroke may help to limit thedifferential diagnosis and treat the etiologic factor more rapidly.