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Ophthalmoplegic Migraine: Inflammatory Neuropathy with Secondary Migraine?

Published online by Cambridge University Press:  02 December 2014

H J McMillan ,
D L Keene ,
P Jacob  and
P Humphreys
H J McMillan
Affiliation:
The Department of Pediatrics, Division of Neurology, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada
D L Keene
Affiliation:
The Department of Pediatrics, Division of Neurology, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada
P Jacob
Affiliation:
The Department of Pediatrics, Division of Neurology, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada
P Humphreys
Affiliation:
The Department of Pediatrics, Division of Neurology, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada
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Abstract

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Background:

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.

Method:

We review 3 new and 37 reported pediatric OM cases.

Results:

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.

Conclusion:

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.

Résumé:

RÉSUMÉ:

La migraine ophtalmoplégique : s'agit-il d'une neuropathie inflammatoire avec migraine secondaire?

Contexte:

Cette revue présente un sommaire du tableau clinique, de la neuroimagerie, du traitement et du pronostic de la migraine ophtalmoplégique (MO) pédiatrique et une analyse critique ce ces données. Bien qu'on classifie la MO comme une forme variante de la migraine, ses manifestations ne cadrent pas avec cette classification. Méthode : Nous rapportons 3 nouvelles observations cliniques pédiatriques de MO et nous révisons 37 observations pédiatriques déjà rapportées. Résultats : La céphalée n'était pas toujours présente et 25% des patients n'avaient pas de douleur au moment du premier épisode de MO. Ànoter que : 1) les symptômes s'estompaient lentement (temps médian de 3 semaines) ; 2) au moment des rechutes, l'atteinte nerveuse avait tendance à être plus sévère et plus persistante ; 3) les patients ayant présenté plusieurs épisodes pouvaient avoir des signes de séquelles neurologiques permanentes (30% des patients) ; 4) la corticothérapie provoquait une amélioration rapide et des épisodes plus courts et 5) un rehaussement transitoire réversible du nerf crânien atteint était observé à l'IRM avec produit de contraste (chez 86% des patients). On ne retrouve pas ces observations dans la céphalée migraineuse primaire. Conclusion : Le clinicien doit posséder une compréhension détaillée de l'histoire naturelle de la MO. Cette revue appuie l'hypothèse selon laquelle la MO résulte d'une inflammation d'un nerf crânien et la céphalée est secondaire et postérieure à cette pathologie.

Type
Original Articles
Information
Canadian Journal of Neurological Sciences , Volume 34 , Issue 3 , August 2007 , pp. 349 - 355
Copyright
Copyright © The Canadian Journal of Neurological 2007

References

1. Headache Classification Subcommittee of the International Headache Society. The international classification of headache disorders. 2nd ed. Cephalalgia. 2004;24 Suppl 1: 9–160.Google Scholar
2. Wong, V, Wong, WC. Enhancement of oculomotor nerve: a diagnostic criterion for ophthalmoplegic migraine? Pediatr Neurol. 1997; 17: 70–3.Google Scholar
3. Hansen, SL, Borelli-Moller, L, Strange, P, Nielson, BM, Olesen, J. Ophthalmoplegic migraine: diagnostic criteria, incidence of hospitalization and possible etiology. Acta Neurol Scand. 1990; 81: 54–60.Google Scholar
4. Durkan, GP, Troost, BT, Slamovits, TL, Spoor, TC, Kennerdell, JS. Recurrent painless oculomotor palsy in children. A variant of ophthalmoplegic migraine? Headache. 1981; 21: 58–62.Google Scholar
5. Miller, NR. Solitary oculomotor nerve palsy in childhood. Am J Ophthalmol. 1977; 83: 106–11.Google Scholar
6. Lance, JW, Zagami, AS. Ophthalmoplegic migraine: a recurrent demyelinating neuropathy? Cephalalgia. 2001; 21: 84–9.Google Scholar
7. Celebisoy, N, Sirin, H, Gokcay, F. Ophthalmoplegic migraine: two patients, one at middle age with abducens palsy. Cephalalgia. 2004; 25: 151–3.Google Scholar
8. Woody, RC, Blaw, ME. Ophthalmoplegic migraine in infancy. Clin Pediatr. 1986; 25: 82–4.Google Scholar
9. Walsh, JP, O’Doherty, DS. A possible explanation of the mechanism of ophthalmoplegic migraine. Neurology. 1960; 10: 1079–84.Google Scholar
10. Vijayan, N. Ophthalmoplegic migraine: ishemic or compressive neuropathy? Headache. 1980; 20: 300–4.Google Scholar
11. Milisavljevic, M, Marinkovic, S, Lolic-Draganic, V, Kovacevic, M. Oculomotor, trochlear, abducens nerve penetrated by cerebral vessels. Arch Neurol 1986; 43: 58–61.Google Scholar
12. Mark, AS, Casselman, J, Brown, D, Sanchez, J, Kolsky, M, Larsen, TC, et al. Ophthalmoplegic migraine: reversible enhancement and thickening of the cisternal segment of the oculomotor nerve on contrast-enhanced MR images. Am J Neuroradiol. 1998; 19: 1887–91.Google Scholar
13. Carlow, TJ. Oculomotor ophthalmoplegic migraine: is it really a migraine? J Neuroophthamol. 2002; 22: 215–21.Google Scholar
14. Carlow, TJ. Oculomotor ophthalmoplegic migraine: what really causes it? J Neuroophthamol. 2003; 23: 240–1.Google Scholar
15. Stidham, DB, Butler, IJ. Recurrent isolated ptosis in presumed ophthalmopleic migraine of childhood. Ophthalmology. 2000; 107: 1476–8.Google Scholar
16. Katz, B, Rimmer, S. Ophthalmoplegic migraine with superiour ramus oculomotor paresis. J Clin Neuroopthamol. 1989; 9: 181–3.Google Scholar
17. Stommel, EW, Ward, TN, Harris, RD. MRI findings in a case of ophthalmoplegic migraine. Headache. 1993; 33: 234–7.Google Scholar
18. De Silva, DA, Siow, JC. A case report of ophthalmoplegic migraine: a differential diagnosis of third nerve palsy. Cephalalgia. 2005; 25: 827–30.Google Scholar
19. Van der Dussen, DH, Bloem, BR, Liauw, L, Ferrari, MD. Ophthalmoplegic migraine: migrainous or inflammatory. Cephalalgia. 2004; 24: 312–5.CrossRefGoogle ScholarPubMed
20. Smith, CD, Reeves, AG. Amelioration of ophthalmoplegic migraine by prednisone: a case report. Headache. 1986; 26: 93–4.CrossRefGoogle ScholarPubMed
21. Bailey, TD, O’Connor, PS, Tredici, TJ, Shacklett, DE. Ophthalmoplegic migraine. J Clin Neuroophthalmol. 1984; 4: 225–8.Google Scholar
22. Prats, JM, Mateos, B, Garaizar, C. Resolution of MRI abnormalities of the oculomotor nerve in childhood ophthalmoplegic migraine. Cephalalgia. 1999; 19: 655–9.CrossRefGoogle ScholarPubMed
23. Ostergaard, JR, Moller, HU, Christensen, T. Recurrent ophthalmoplegia in childhood: diagnostic and etiologic considerations. Cephalalgia. 1996; 16: 276–9.Google Scholar
24. Ramelli, GP, Vella, S, Loublad, K, Remonda, L, Vassella, F. Swelling of the third nerve in a child with transient oculomotor paresis: a possible cause for ophthalmoplegic migraine. Neuropediatrics. 1999; 31: 145–7.Google Scholar
25. Elser, JM, Woody, RC. Migraine headache in the infant and young child. Headache. 1990; 30: 366–8.Google Scholar
26. O’Hara, MA, Anderson, RT, Brown, D. Magnetic resonance imaging of ophthalmoplegic migraine of children. J AAPOS. 2001; 5: 307–10.Google Scholar
27. De Renzi, E, Nichelli, P. Ophthalmoplegic migraine with persistent abducens nerve palsy. Eur Neurol. 1977; 15: 227–30.Google Scholar
28. Kandt, RS, Goldstein, GW. Steroid-responsive ophthalmoplegia in a child. Arch Neurol. 1985; 42: 589–91.Google Scholar
29. Sanchez del Rio, M, Reuter, U, Moskowitz, MA. Central and peripheral mechanisms of migraine. Funct Neurol. 2000; 15 Suppl 3; 157–62.Google Scholar
30. Shin, DJ, Kim, JH, Kang, SS. Ophthalmoplegic migraine with reversible thalamic ischemia shown by brain SPECT. Headache. 2002; 42: 132–5.Google Scholar
31. Waeber, C, Moskowitz, MA. Migraine as an inflammatory disorder. Neurology. 2005; 64: S9–S15.Google Scholar
32. Amit, R, Benezra, D. Oculomotor ophthalmoplegic migraine in an infant. Headache. 1987; 27: 390–1.Google Scholar
33. Troost, BT. Ophthalmoplegic migraine. Biomed Pharmacother. 1996; 50: 49–51.Google Scholar
34. Weiss, AH, Phillips, JO. Ophthalmoplegic migraine. Pediatr Neurol. 2004; 30: 64–6.Google Scholar