Recurrent Painful Ophthalmoplegic Neuropathy in an Adult Patient: A Case Report With Literature Review

A Case of Adult-Onset Recurrent Painful Ophthalmoplegic Neuropathy With Bilateral Ophthalmoplegia

“…A 40-year-old male with a severe unilateral migraine headache of long duration was diagnosed with RPON and, three days later, developed ipsilateral ophthalmoplegia, both of which subsided with a tapering dose of oral steroids and migraine prophylaxis [2]. Diplopia, pain with eye movement, and nodular enhancement seen on MRI orbit of a 50-year-old female with RPON were resolved with 20 mg of oral prednisone twice daily for six months [3]. A 48-year-old woman who had ocular nerve palsy and migraine attacks every 1-2 months was diagnosed with RPON, and like our patient, her symptoms resolved immediately with prednisolone [9].…”

“…Formerly classified as a migraine, it is now classified by the International Classification of Headache Disorders (ICHD) as a type of neuropathy and facial pain [1]. Although RPON is most commonly seen in children, adult cases have also been documented [2,3]. The etiology of RPON has no clinical consensus, but it is speculated to be related to nerve inflammation, nerve demyelination, or neurovascular compression [4][5][6].…”