Ophthalmoplegic Migraine and Infundibular Dilatation of a Cerebral Artery

Authors: Vieira, José Pedro; Castro, Jorge; Gomes, Leonor Bastos; Jacinto, Sandra; Dias, Ana

Source: Headache: The Journal of Head and Face Pain, Volume 48, Number 9, October 2008 , pp. 1372-1374(3)

Publisher: Blackwell Publishing

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Abstract:

Ophthalmoplegic migraine (OM) is a childhood disorder of uncertain etiology manifesting recurrent unilateral headache associated with a transitory oculomotor (usually IIIrd nerve) palsy. Recent publications emphasize the finding on MRI of contrast enhancement in the IIIrd nerve suggesting that OM may be a recurrent inflammatory neuropathy.

We report the case of a 7-year-old boy with typical symptoms of this disorder. Angio MR and Angio CT revealed the presence of an infundibular dilatation of a perforating branch of the posterior cerebral artery adjacent to the symptomatic IIIrd nerve. We speculate that this and perhaps other cases of OM may have a different pathophysiology related to compression of the IIIrd nerve by an adjacent vascular structure that could activate the trigeminovascular system and produce migrainous pain.

Keywords: ophthalmic migraine; headache; cerebral artery

Document Type: Research article

DOI: 10.1111/j.1526-4610.2008.01179.x

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