Ophthalmoplegic Migraine: Migrainous or Inflammatory?

Dussen, D H van der; Bloem, B.R.; Liauw, Lishya; Ferrari, Michel D.

doi:10.1111/j.1468-2982.2004.00669.x

Cited by 41 publications

(44 citation statements)

References 13 publications

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“…Lee et al [17] reported on a patient with ophthalmoplegic migraine with recurring abducens palsy with headache who was found on MRI to have reversible enhancement of the abducens nerve in the pons, lending further credence to this possible underlying pathophysiology. van der Dussen et al [18] recently reported a case of recurrent ophthalmoplegic migraine with oculomotor and trochlear palsies and reversible MRI enhancement and thickening of the trochlear nerve.…”

Section: Discussionmentioning

confidence: 97%

Ophthalmoplegic migraine

Levin

Ward

2004

Current Science Inc

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Ophthalmoplegic migraine is a rare condition, previously thought to represent a variant of migraine. Recent observations regarding its usual clinical presentation and common magnetic resonance imaging findings have given rise to speculation that this illness is more likely to represent an inflammatory cranial neuropathy. The recent revision of the International Headache Classification has reclassified ophthalmoplegic migraine from a subtype of migraine to the category of neuralgia. In this article, potential pathophysiological mechanisms are discussed. The typical clinical presentation of ophthalmoplegic migraine generally involves transient migraine-like headache accompanied by often long-lasting oculomotor, abducens or, rarely, trochlear neuropathy with diplopia and (if oculomotor nerve is involved) pupillary abnormalities and ptosis. Ophthalmoplegic migraine generally occurs in children, but a number of adult cases have been reported. Prognosis is good because symptoms almost always resolve, but, after several episodes, some deficits may persist. Differential diagnosis is rather large, although most other possible causes of ophthalmoplegia and headache have distinctive presentations or can be excluded with fairly straightforward diagnostic testing. Optimal prophylactic and acute treatment is still unclear, but migraine prophylactic medications such as b blockers and calcium channel blockers have been proposed. Steroids have been used with mixed results.

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Section: Discussionmentioning

confidence: 97%

Ophthalmoplegic migraine

Levin

Ward

2004

Current Science Inc

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“…However, van der Dussen et al [54] reported a patient with both third and fourth cranial nerve involvement in a scenario compatible with opthalmoplegic migraine. The patient had evidence of fourth nerve enhancement on MRI scanning but also there was an elevated cerebrospinal fluid-IgG index compatible with an inflammatory etiology.…”

Section: Assorted Observationsmentioning

confidence: 97%

Visual disturbances and migraine

Maxner

Moeller

2005

Curr Neurol Neurosci Rep

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There is a close relationship between headache and the visual system. Visual symptoms are prominent features of clinical syndromes such as migraine, cluster headache, and the trigeminal autonomic cephalgias. There are also strong links between headache and the visual system on the basis of genetics, molecular biology, neurophysiology, and neuroimaging. Studies of these links are leading to the development of novel therapies for a variety of headache syndromes. This review is designed to summarize the most recent literature on headache and the visual system. A particular emphasis is placed on publications of interest to clinicians.

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“…Com base nestes dados, muitos autores consideram atualmente que a EO esteja mais relacionada com uma forma de neuropatia inflamatória ou desmielinizante recorrente que compromete os nervos oculomotores (1,5,12) . A EO é uma entidade rara com manifestação inicial na idade adulta, constituindo sempre diagnóstico de exclusão.…”

Section: Discussionunclassified