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Ophthalmoplegic migraine with trigeminal nerve involvement
Bhawna Sharma1, Raghavendra Bakki Sannegowda, Sunil Kumar
1Department of Neurology, SMS Medical College Hospital, Jaipur, Rajasthan, India. sharmadrbhawna@gmail.com
BMJ Case Reports
|May 30, 2013
Summary
A rare case of migraine-associated trigeminal nerve (fifth nerve) palsy and third nerve palsy is presented. This report details a unique presentation of ophthalmoplegic migraine involving cranial nerves V1 and III, with full recovery following steroid treatment.
Area of Science:
- Neurology
- Neuro-ophthalmology
Background:
- Ophthalmoplegic migraine typically involves the oculomotor nerve (third cranial nerve).
- Cranial nerve involvement in migraine attacks is a recognized, though uncommon, phenomenon.
Observation:
- A 25-year-old male experienced third nerve palsy and trigeminal nerve V1 sensory loss during a severe migraine.
- Brain and cavernous sinus imaging, including MRI and CT angiogram, revealed no abnormalities or nerve enhancement.
Findings:
- This case represents the first reported instance of trigeminal nerve involvement in ophthalmoplegic migraine.
- The patient demonstrated a complete, uneventful recovery within two weeks of initiating oral steroid therapy.
Implications:
- This case expands the spectrum of cranial nerve palsies associated with ophthalmoplegic migraine.
- It suggests that the trigeminal nerve may also be affected in this condition, challenging previous understandings.
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