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A Pediatric Case of Ophthalmoplegic Migraine with Recurrent Oculomotor Nerve Palsy

Ishikawa1, Yoshihara, Mizuki

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

Japanese Journal of Ophthalmology
|October 18, 2000
PubMed

Insights

Ophthalmoplegic migraine can cause recurrent oculomotor nerve palsy in children. Early diagnosis relies on detailed patient history, and topical timolol maleate may reduce migraine frequency and symptoms.

Area of Science:

  • Ophthalmology
  • Neurology

Background:

  • Ophthalmoplegic migraine is a rare condition characterized by recurrent cranial nerve palsies.
  • Oculomotor nerve palsy can present with symptoms like ptosis and double vision.

Purpose of the Study:

  • To report a case of ophthalmoplegic migraine in a young child presenting with recurrent oculomotor nerve palsy.
  • To highlight the importance of considering ophthalmoplegic migraine in the differential diagnosis of childhood oculomotor nerve palsy.

Main Methods:

  • A case study of a 4-year-old girl with recurrent ptosis and double vision.
  • Diagnostic workup included electroencephalography, computed tomography, single photon emission computed tomography, and cerebrovascular Doppler-ultrasound.
  • Treatment involved topical timolol maleate.

Main Results:

  • The patient experienced recurrent left oculomotor nerve palsy with internal ophthalmoplegia.
  • Neuroimaging and electroencephalography showed no significant abnormalities.
  • Topical timolol maleate significantly reduced the frequency and severity of migraine symptoms and oculomotor nerve palsy episodes.

Conclusions:

  • Ophthalmoplegic migraine should be considered in the diagnosis of isolated oculomotor nerve palsy in childhood.
  • A thorough patient history is crucial for diagnosing this condition.
  • Topical timolol maleate may be an effective treatment for managing symptoms.

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