Ophthalmoplegic migraine with onset in adulthood – a case report
Keywords:
ophthalmoplegic migraine, oculomotor nerveAbstract
Ophthalmoplegic migraine (OM) is a rare form of primary headache characterized by migraine attack accompanied by oculomotor nerve palsy, with typical disease onset in childhood. Nevertheless there are some reports on adult-onset of OM. The cranial nerve most commonly affected is oculomotor nerve (55%), but the palsy may affect different nerves in the same patient. The prevalence of the disease is less that 1 case in a million and in adults the diagnosis is exceptional as requires exclusion of other alternative causes of painful oculomotor nerve palsy such as vascular aneurysm, myasthenia gravis, oculomotor nerve schwannoma, pituitary apoplexy, Tolosa-Hunt syndrome, mucomycosis, diabetes mellitus or idiopathic cranial palsy. The pathophysiology of the disease remains unknown. The aim of this study was to describe an rare adulthood-onset case of OM.
References
1. Hansen S.L., Borelli-Møller L., Strange P., Nielsen B.M., Olesen J. Ophthalmoplegic migraine: diagnostic criteria, incidence of hospitalization and possible etiology. Acta Neurol. Scand., 1990; 81: 54-60.
2. Vehagen W.I.M., Prick M.J.J., AZN Dijk van R. Onset of ophthalmoplegic migraine with abducens palsy at the middle age? Headache, 2003; 43: 798-800.
3. Lal V., Sahota P., Singh P., Gupta A., Prabhakar S. Ophthalmoplegia with migraine in adults: is it ophthalmoplegic migraine? Headache, 2009; 49: 838-850.
4. Pearce J. The ophthalmological complications of mi-graine. J Neurol Sci 1968; 6: 73-81.
5. De Silva D.A., Siow H.C. A case report of ophthalmoplegic migraine: a differential diagnosis of thrird nerve palsy. Cephalalgia, 2005; 25: 827-830.
6. Mark A.S., Casselman J., Brown D., Sanchez J., Kolsky M., Larsen T.C. 3rd, Lavin P., Ferraraccio B. Ophthalmoplegic migraine: reversible enhacement and thickening of the cisternal segment of the oculomotor nerve on contrast enhacement MR images. Am. J. Neuroradiol., 1998; 19: 1887-1891.
7. Headache Classification Subcomitee of the International Headache Society. The International Classification of Headache Disorder, 2nd Edn. Cephalalgia, 2004; 24: 9-160.
8. Giraud P., Valade D., Lanteri-Minet M. et al. Is migaine with cranial nerve palsy an ophthalmoplegic migraine? J. Headache Pain, 2007; 8: 119-122.
9. Donahue H.C. Migraine and its ocular manifestations. Trans Am. Ophthalmol. Soc., 1949; 47: 554-605.
