Oculomotor Ophthalmoplegic Migraine: Is It Really Migraine?

Abstract

Oculomotor ophthalmoplegic migraine is a rare episodic childhood condition in which a unilateral oculomotor palsy is preceded by headache. I describe six new cases that had magnetic resonance imaging signal abnormalities during the acute phase, consisting of a thickened and enhancing ipsilateral oculomotor nerve at its exit from the midbrain. During the quiescent phase, when the headache had resolved, the signal abnormalities were still present but less dramatic. Seventeen similar cases have been previously reported. The pathophysiology may be a trigeminovascular migraine epiphenomenon that is dependent on the unique oculomotor nerve anatomy and porous blood-nerve barrier at the emergence of the oculomotor nerve from the brainstem and the sequelae of demyelination. Early high-dose corticosteroid treatment is recommended to rapidly resolve an acute episode and to potentially prevent permanent abnormal oculomotor nerve signs.

P Ediatric Isolated Oculomotor Nerve Schwannoma: A Rare Case Report

“…6 Oculomotor nerve schwannoma is exceptionally rare in children with only 13 cases reported so far. 7 Including our patient, there have been six male and eight female patients, ranging in age from 15 months to 16 years, with a mean age of 9.1 years.…”

Enxaqueca oftalmoplégica: relato de caso

“…A revisão de Carlow reune casos de necropsia de pacientes com EO cuja descrição histopatológica em três deles é compatível com hipertrofia e formação cicatricial no nervo comprometido, conseqüentes a episódios repetidos de desmielinização e remielinização (11) . Estes achados concordam com as alterações de imagem observadas no exame de RM.…”

Ophthalmoplegic migraine: Still a diagnostic dilemma?

“…Carlow [ 11 ] studied the magnetic resonance scans in six patients diagnosed with OM and did a retrospective literature survey in 17 patients with OM, all of whom showed the presence of magnetic resonance signal abnormalities. Noncontrast T 1 -weighted images documented thickened ipsilateral oculomotor nerves at the midbrain exit that were isodense with the brain.…”