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[Recurrent oculomotor paralysis in childhood--long-term follow-up]
Background:
The underlying pathology of recurrent IIIrd (and VIth) Nerve palsy are often unknown. Long-term observation sometimes reveal surprising causes.
Patient:
At the first presentation in the clinic the patient was 5 years old and suffered from the second episode of the palsy (which regressed quickly). Two recurrences followed in intervals of 1 to 2 years, the first lasted for days, the second for months. In the last palsy transient synkinesis of the upper lid was seen. Three of the four events were preceded by gastrointestinal or respiratory infection. Pediatric and neurological findings and NMR were normal. Later, the girl suffered from migraine with gastrointestinal involvement.
Conclusion:
Migraine can be masked by gastrointestinal or respiratory infection.