The borderland of migraine with aura: episodic unilateral mydriasis

Maggioni, Ferdinando; Mainardi, Federico; Malvindi, Maria Lucia; Zanchin, Giorgio

doi:10.1007/s10194-010-0255-7

Cited by 20 publications

(8 citation statements)

References 15 publications

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“…The connection between BEM and migraine is not precisely known. Some authors consider BEM to be a migraine aura, 8 while most previous studies have regarded it as a nonaura symptom that accompanies migraine. 7 It has even been described as a form of ophthalmoplegic migraine without impaired external motility involving the third cranial nerve.…”

Section: Discussionmentioning

confidence: 99%

Benign episodic mydriasis. Experience in a specialist neuro-ophthalmology clinic of a tertiary hospital

Martín-Santana

González-Hernández

Tandón-Cárdenes

et al. 2015

Neurología (English Edition)

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Introduction: Anisocorias are a relatively frequent reason for consultation in neuroophthalmology units. They remain a diagnostic challenge for specialists as they may be due to several aetiological factors. In the absence of other accompanying symptoms, anisocorias are usually due to benign processes. Benign episodic mydriasis (BEM) is an isolated cause of intermittent pupil asymmetry in which the pathophysiology is still not fully understood; it is predominant in young women with migraine.Subjects, material, and methods: We describe the epidemiological and clinical characteristics of patients with BEM, assessed in a neuro-ophthalmology unit in a tertiary hospital.Results: A total of 7 patients were diagnosed with BEM, all of them females, with a mean age of 33 ± 10 years. The patients presented with pupil asymmetry (n = 5) and blurred vision (n = 2), and 6 of the 7 patients had unilateral involvement. The duration of impairment varied from a few minutes to 48 hours. Four patients (57%) had a clinical history of migraine without aura. The episodes in these 4 patients were recurrent (75%), often lasted for a few minutes (75%), and had associated blurred vision (50%). The neuroimaging studies were normal.Discussion: BEM appears predominantly in young women. It is frequently related to a previous history of migraine, and the specialist must consider if it is a concomitant symptom of common migraine, migraine with aura, or ophthalmoplegic migraine. Although BEM has unilateral predominance, there may be alternation of the affected eye or even bilateral impairment during the same episode, which makes us question the adequacy of the term to describe the process. Imaging tests are not recommended in the absence of other accompanying symptoms, or in short-term episodes. Benign episodic mydriasis in a neuro-ophthalmology clinic 291 PALABRAS CLAVE Anisocoria; Aura inusual; Equivalentes migrañosos; Midriasis benigna episódica; Migraña sin aura; Migraña oftalmopléjica Midriasis benigna episódica. Experiencia en una consulta monográfica de neuro-oftalmología de un hospital terciario ResumenIntroducción: Las anisocorias son un motivo de consulta relativamente frecuente en unidades de neuro-oftalmología (UNO). Suponen un reto diagnóstico por la variedad de procesos que pueden ocasionarla. En ausencia de síntomas acompañantes, suelen estar ocasionadas por procesos benignos. La midriasis benigna episódica (MBE) es una causa aislada de asimetría pupilar intermitente, de fisiopatología no esclarecida y predominio en mujeres jóvenes migrañosas.Sujetos, material y métodos: Describimos las características epidemiológicas y clínicas de los pacientes con MBE valorados en una UNO de un hospital terciario.Resultados: Un total de 7 pacientes fueron diagnosticadas de MBE. Todas eran mujeres, con edad media de 33 ± 10 años. Los motivos de consulta fueron asimetría pupilar (n = 5) y visión borrosa (n = 2) de presentación fundamentalmente unilateral (n = 6). La duración fue variable, desde minutos hasta 48 h. Cuatro pacientes (57%) presentaban...

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Section: Discussionmentioning

confidence: 99%

Benign episodic mydriasis. Experience in a specialist neuro-ophthalmology clinic of a tertiary hospital

Martín-Santana

González-Hernández

Tandón-Cárdenes

et al. 2015

Neurología (English Edition)

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“…1 ), particularly in mydriasis (70.7%). The role of pupillary disorders in migraine patients is not completely understood [ 7 , 8 ]. The association between migraine and monolateral or bilateral “tonic pupil” [ 9 , 10 ] might be caused by hyperactivity of the sympathetic nervous system or hypoactivity of the parasympathetic system [ 8 ].…”

Section: Discussionmentioning

confidence: 99%

A cohort study on acute ocular motility disorders in pediatric emergency department

et al. 2018

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BackgroundAcute ocular motility disorders (OMDs) in children admitted to Emergency Department (ED) represents a not so rare condition with a wide spectrum of different etiologies. The emergency physician must be skilled in rapidly identifying patients with potentially life threatening (LT) forms, requiring further diagnostic procedures. The aim of the study was to assess characteristics of children with acute Ocular Motility Disorders (OMDs), and to identify “red flags” for recognition of underlying life-threatening (LT) conditions.MethodsA retrospective cohort study evaluated children (2 months-17 years) admitted to a tertiary Emergency Department in 2009–2014. A subgroup analysis was performed comparing children with and without LT conditions.ResultsOf 192 visits for OMDs, the isolated strabismus occurred most frequently (55.6%), followed by pupil disorders (31.8%), ptosis (5.2%) and combined OMDs (11.5%). The majority of acute OMDs involved no underlying LT conditions (n = 136) and most of them were infants or toddlers (50%). In a multivariable analysis, LT conditions included especially children over 6 years of age, increasing the odds ratio by 2% for each months of age (p = 0.009). LT etiologies were 16 times more likely in combined OMDs (p = 0.018), were over 13 times more likely to report associated extra-ocular signs/symptoms (p = 0.017) and over 50 times more likely to report co-morbidity (p = 0.017).ConclusionOMDs are not an uncommon presentation at ED. Although most of them involve non-LT conditions, the ED physician should consider potential “red flags” for appropriate management of children such as age > 6 years, combined OMDs, extra-ocular symptoms and co-morbidity.

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“…kranial sinir içindeki parasempatik lif disfonksiyonu ile veya trigeminovasküler sistem aktivasyonu ile Willis poligonunda salınan nöropeptidlerin yapmış oldukları ödem ve inflamasyona bağlı beyin sapı çıkışında III. kranial sinirde demyelinizasyon ile ilişkili olabileceği düşünülmektedir (3,10,11). Benign epizodik unilateral midriazis klinik pratikte nadir görülen bir tablo olup, tanının akılda tutulması, gerekli olmayan girişimsel tetkiklerin yapılmasını engelleyebilir (3).…”

Section: Discussionunclassified

Benign Epizodik Unilateral Midriazis (Olgu Sunumu)

Değirmenci¹,

Tekin²,

Erdoǧan³

et al. 2012

Tnd

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Ya z›fl ma Ad re si/Ad dress for Cor res pon den ce: Dr. Eylem Değirmenci, Pamukkale Üniversitesi, Tıp Fakültesi Hastanesi, Nöroloji Anabilim Dalı, Denizli, Türkiye Gsm: +90 532 622 82 02 E-posta: eylemteke@yahoo.com Ge lifl Ta ri hi/Re cei ved: 15.02.2012 Ka bul Ta ri hi/Ac cep ted: 12.08.2012 ÖzetBenign epizodik midriazis çoğunluğu migrenöz kadınlarda olmak üzere genç erişkinlerde ortaya çıkabilen tekrarlayan izole unilateral midriazis atakları için kullanılan tanımlayıcı bir terimdir. Yazımızda aralıklı olarak sol gözbebeğinde büyüme şikayeti ile başvuran ve anizokori etiyolojisine yönelik tetkiklerin sonucunda benign epizodik unilateral midriazis tanısı alan 20 yaşında erkek hasta sunulacaktır. Benzer olgularda anizokori etiyolojisinin benign sebeplerinin akılda tutulması hastalara gerekli olmayan girişimsel tanısal yöntemlerin uygulanmaması konusunda uyarıcı olabilir. (Türk Nöroloji Dergisi 2012; 18:111-3) Anah tar Ke li me ler: Anizokori, benign, midriazis Sum maryBenign episodic unilateral mydriasis is a descriptive condition with recurrent unilateral mydriasis in adults, especially women with migraine. We report a 20 year-old male presenting with paroxysmal left pupil mydriasis and diagnosed as benign episodic unilateral mydriasis after exclusion of other reasons causing anisocoria.

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The borderland of migraine with aura: episodic unilateral mydriasis

Cited by 20 publications

References 15 publications

Benign episodic mydriasis. Experience in a specialist neuro-ophthalmology clinic of a tertiary hospital

Benign episodic mydriasis. Experience in a specialist neuro-ophthalmology clinic of a tertiary hospital

A cohort study on acute ocular motility disorders in pediatric emergency department

Benign Epizodik Unilateral Midriazis (Olgu Sunumu)

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