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[A pediatric case of ophthalmoplegic migraine with recurrent oculomotor nerve palsy]

H Ishikawa1, M Yoshihara, K Mizuki

  • 1Department of Ophthalmology, Nihon University School of Medicine, Tokyo, Japan.

Nippon Ganka Gakkai Zasshi
|April 7, 2000
PubMed

Insights

Ophthalmoplegic migraine can cause recurrent oculomotor nerve palsy in children. Timolol maleate eye drops effectively reduced migraine frequency and symptoms in a young patient.

Area of Science:

  • Neurology
  • Ophthalmology

Background:

  • Ophthalmoplegic migraine is a rare disorder characterized by recurrent cranial nerve palsies, most commonly affecting the oculomotor nerve.
  • Diagnosis can be challenging, especially in young children, due to overlapping symptoms with other neurological conditions.

Observation:

  • A 4-year-old girl presented with recurrent episodes of left ptosis and double vision, accompanied by drowsiness and vomiting.
  • Clinical examination revealed left oculomotor nerve palsy with internal ophthalmoplegia, which resolved spontaneously.
  • Neuroimaging and electroencephalography showed no significant abnormalities.

Findings:

  • The patient experienced two further episodes of isolated oculomotor nerve palsy and mydriasis.
  • Topical timolol maleate (0.25% twice daily) significantly reduced the frequency and severity of migraine attacks and associated symptoms.
  • This suggests a potential therapeutic role for beta-blockers in managing ophthalmoplegic migraine.

Implications:

  • Ophthalmoplegic migraine should be considered in the differential diagnosis of isolated oculomotor nerve palsy in childhood.
  • A thorough case history focusing on recurrent migraine symptoms is crucial for accurate diagnosis.
  • This case highlights the importance of considering migraine as a cause of recurrent cranial nerve palsies in pediatric patients.
Abstract

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