Subject(s)
Ophthalmoplegic Migraine/pathology , Child , Humans , Male , Oculomotor Nerve/pathology , Recurrence , Trochlear Nerve/pathologyABSTRACT
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Subject(s)
Female , Humans , Male , Ophthalmoplegic Migraine/metabolism , Ophthalmoplegic Migraine/pathology , Medical History Taking/methods , Therapeutics/methods , Ophthalmoplegic Migraine/complications , Ophthalmoplegic Migraine/diagnosis , Medical History Taking/standards , Therapeutics , Review Literature as TopicABSTRACT
INTRODUCTION: The International Classification of Headache Disorders classifies ophthalmoplegic migraine (OM) under "cranial neuralgias and central causes of facial pain." OM is diagnosed when all the following criteria are satisfied: A. At least two attacks fulfilling criterion B. B. Migraine-like headache accompanied or followed within four days of its onset by paresis of one or more of the III, IV and/or VI cranial nerves. C. Parasellar orbital fissure and posterior fossa lesions ruled out by appropriate investigations. In children the syndrome is rare and magnetic resonance (MR) shows strongly enhancing thickened nerve at the root entry zone (REZ). METHOD: The authors review the literature focusing on pathogenesis theories. RESULTS: The authors suggest that ischemic reversible breakdown of the blood-nerve barrier is the most probable cause of OM and to include MR findings in the hallmarks of the disease. CONCLUSION: OM is the same disease in adulthood and childhood, even if in adults the MR imaging findings are negative. In the authors' opinion, OM should be classified as migraine.
Subject(s)
Ophthalmoplegic Migraine/classification , Ophthalmoplegic Migraine/pathology , Ophthalmoplegic Migraine/physiopathology , Adult , Child , HumansABSTRACT
BACKGROUND: Ophthalmoplegic migraine (OM) is a rare condition characterized by the association of headaches and an oculomotor nerve palsy. The third cranial nerve is commonly involved in recurrent attacks, whereas involvement of the sixth and fourth nerves is uncommon. It is still debated whether an uncontrolled migraine or an oculomotor neuropathy may be the primary cause of ophthalmoplegic migraine. CASES: We report two patients affected by OM with normal magnetic resonance imaging findings and a history of uncontrolled migraine before an attack of OM. CONCLUSION: The cases reported allow us to hypothesize that OM may be considered a form of migraine rather than a cranial neuralgia. It is possible that different factors such as inflammatory or structural factors, may represent a vulnerability of the nerve during a severe migraine attack causing ophthalmoplegia.
