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Arquivos de Neuro-Psiquiatria

Print version ISSN 0004-282X

Arq. Neuro-Psiquiatr. vol.70 no.1 São Paulo Jan. 2012 



Magnetic resonance appearance of recurrent ophthalmoplegic migraine


Aspectos de ressonância magnética na enxaqueca oftalmoplégica recorrente



Antônio José da RochaI; Paulo BreinisII; Mario Luiz R MonteiroIII

ISection of Neuroradiology, Fleury Medicina e Saúde, São Paulo SP, Brazil
IIPediatric Neurologist, Faculdade de Medicina do ABC, Santo André SP, Brazil
IIIDivision of Ophtalmology and Laboratory of Ophtalmological Investigations (LIM-33), University of São Paulo Medical School, São Paulo SP, Brazil




A 5-year-old boy presented with severe frontal headache followed by right cranial nerve paresis. His previous medical history, blood tests and CSF analysis were unremarkable, and he made a full recovery after 4 weeks. Nevertheless, a similar episode occurred 5 years later. Magnetic resonance imaging follow-up supported diagnosis of recurrent ophthalmoplegic migraine (Figure).

This rare form of migraine, which mainly affects children1, may present as a triad of symptoms consisting of migraine ophthalmoplegia (nerve palsy) and focal enhancement of an enlarged third cranial nerve at the root exit zone. However, other diagnoses must be ruled out. The controversial pathogenesis of the condition may stem from the reversible breakdown of the blood-brain barrier due to vasospasm during the migraine attack or recurrent demyelinating neuropathy1,2.



1. Miglio L, Feraco P, Tani G, Ambrosetto P. Computed tomography and magnetic resonance imaging findings in ophthalmoplegic migraine. Pediatr Neurol 2010;42:434-436.         [ Links ]

2. Bharucha DX, Campbell TB, Valencia I, Hardison HH, Kothare SV. MRI findings in pediatric ophthalmoplegic migraine: a case report and literature review. Pediatr Neurol 2007;37:59-63.         [ Links ]



Antônio José da Rocha
Rua Cincinato Braga 232
01333-910 São Paulo SP - Brasil

Conflict of interest:
There is no conflict to interest to declare.

Received 19 August 2011
Received in final form 15 September 2011
Accepted 22 September 2011

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