Ophthalmoplegic “Migraine” or Recurrent Ophthalmoplegic Cranial Neuropathy: New Cases and a Systematic Review

Ophthalmoplegic migraine is a poorly understood neurologic syndrome characterized by recurrent bouts of head pain and ophthalmoplegia. By reviewing cases presenting to our centers in whom the phenotype has been carefully dissected, and systematically reviewing all published cases of ophthalmoplegic...

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Bibliographic Details
Published in:Journal of child neurology 2012-06, Vol.27 (6), p.759-766
Main Authors: Gelfand, Amy A., Gelfand, Jeffrey M., Prabakhar, Prab, Goadsby, Peter J.
Format: Article
Language:English
Subjects:
Adolescent
Adrenal Cortex Hormones - therapeutic use
Child
Corticoids
Cranial Nerve Diseases - cerebrospinal fluid
Cranial Nerve Diseases - complications
Cranial Nerve Diseases - drug therapy
Data processing
Databases, Bibliographic - statistics & numerical data
Demyelination
Etiology
Female
Head
Headache
Humans
Magnetic Resonance Imaging
Male
Migraine
Nerves
Neuralgia
Neuropathy
Oculomotor nerve
Ophthalmoplegia
Ophthalmoplegia - cerebrospinal fluid
Ophthalmoplegia - complications
Ophthalmoplegia - drug therapy
Ophthalmoplegic Migraine - cerebrospinal fluid
Ophthalmoplegic Migraine - complications
Ophthalmoplegic Migraine - drug therapy
Pain
Skull
Young Adult
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Summary:Ophthalmoplegic migraine is a poorly understood neurologic syndrome characterized by recurrent bouts of head pain and ophthalmoplegia. By reviewing cases presenting to our centers in whom the phenotype has been carefully dissected, and systematically reviewing all published cases of ophthalmoplegic migraine in the magnetic resonance imaging (MRI) era, this review sets out to clearly define the syndrome and discuss possible etiologies. We found that in up to one-third of patients, the headache was not migrainous or associated with migrainous symptoms. In three-quarters of the cases involving the third nerve, there was focal nerve thickening and contrast enhancement on MRI. Observational data suggest systemic corticosteroids may be beneficial acutely. The etiology remains unclear, but may involve recurrent bouts of demyelination of the oculomotor nerve. “Ophthalmoplegic migraine” is a misnomer in that it is probably not a variant of migraine but rather a recurrent cranial neuralgia. A more appropriate name might be “ophthalmoplegic cranial neuropathy.”
ISSN:0883-0738
1708-8283
DOI:10.1177/0883073811426502