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Neuromuscular hamartoma is a possible primary pathology of oculomotor ophthalmoplegic migraine

Jiro Akimoto1, Shinjiro Fukami, Ryo Hashimoto

  • 1Department of Neurosurgery, Tokyo Medical University, Japan.

Cephalalgia : an International Journal of Headache
|December 17, 2011
PubMed
Abstract

Insights

Oculomotor ophthalmoplegic migraine (O-OPM) in a man was linked to a rare neuromuscular hamartoma. This congenital mass in the oculomotor nerve

Area of Science:

  • Neurology
  • Pathology
  • Ophthalmology

Background:

  • Oculomotor ophthalmoplegic migraine (O-OPM) is observed in children, sometimes with MRI-detected masses at the oculomotor nerve's root exit zone (REZ).
  • These masses are hypothesized to stem from nerve hypertrophy due to recurrent demyelination.

Observation:

  • A 51-year-old man with O-OPM since age 6 experienced worsening migraine frequency and intensity.
  • Brain MRI revealed a small nodular mass in the REZ of the oculomotor nerve.
  • Initial diagnosis suggested oculomotor schwannoma, but biopsy revealed a neuromuscular hamartoma due to adherence and hemorrhage.

Findings:

  • Pathological diagnosis confirmed a neuromuscular hamartoma in the REZ of the oculomotor nerve.
  • This hamartoma was tightly adhered to and hemorrhagic, complicating surgical intervention.

Implications:

  • A small nodular mass in the REZ of the oculomotor nerve may represent a hamartoma with congenital origins.
  • This hamartoma could be the primary cause of O-OPM in specific cases.
  • Further research into congenital factors and hamartomas in O-OPM is warranted.

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