Ophthalmoplegic Migraine: Inflammatory Neuropathy with Secondary Migraine?

This critical review provides a summary of the clinical presentation, neuroimaging, treatment and prognosis in pediatric ophthalmoplegic migraine (OM). The features of OM are not in keeping with its classification as a migraine-variant. We review 3 new and 37 reported pediatric OM cases. Headache wa...

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Bibliographic Details
Published in:Canadian journal of neurological sciences 2007-08, Vol.34 (3), p.349-355
Main Authors: McMillan, H J, Keene, D L, Jacob, P, Humphreys, P
Format: Article
Language:English
Subjects:
Adolescent
Adrenal Cortex Hormones - therapeutic use
Age of Onset
Anti-Inflammatory Agents - therapeutic use
Biological and medical sciences
Child
Child, Preschool
Cranial nerves. Spinal roots. Peripheral nerves. Autonomic nervous system. Gustation. Olfaction
Female
Humans
Infant
Magnetic Resonance Imaging
Male
Medical sciences
Migraine Disorders - diagnosis
Migraine Disorders - etiology
Migraine Disorders - physiopathology
Nervous system (semeiology, syndromes)
Neuritis - complications
Neuritis - diagnosis
Neuritis - physiopathology
Neurology
Oculomotor Nerve - pathology
Oculomotor Nerve - physiopathology
Oculomotor Nerve Diseases - complications
Oculomotor Nerve Diseases - diagnosis
Oculomotor Nerve Diseases - physiopathology
Ophthalmoplegia - complications
Ophthalmoplegia - diagnosis
Ophthalmoplegia - physiopathology
Original Articles
Recurrence
Time Factors
Vascular diseases and vascular malformations of the nervous system
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Description
Summary:This critical review provides a summary of the clinical presentation, neuroimaging, treatment and prognosis in pediatric ophthalmoplegic migraine (OM). The features of OM are not in keeping with its classification as a migraine-variant. We review 3 new and 37 reported pediatric OM cases. Headache was an inconsistent feature, with 25% patients showing no evidence of pain at the initial OM episode. Patients demonstrated: 1) prolonged time for symptom resolution to occur (median time 3 weeks); 2) tendency for recurrent episodes to have more severe and persistent nerve involvement; 3) evidence of permanent neurological sequelae with recurrent episodes (30% of patients); 4) rapid improvement and shortened duration with corticosteroid therapy and; 5) transient, reversible MRI contrast enhancement of the affected cranial nerve (86% of patients). These features would not be expected in primary migraine headache. A detailed understanding of the natural history of OM is essential for the clinical. This review provides support that OM may result from cranial nerve inflammation with headache a secondary and later feature of this condition.
ISSN:0317-1671
2057-0155
DOI:10.1017/S0317167100006818