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Related Experiment Videos

Internal ophthalmoplegia associated with migraine attacks

M Leone1, L Grazzi, F Moschiano

  • 1Carlo Besta Neurological Institute, Milan, Italy.

Cephalalgia : an International Journal of Headache
|December 1, 1994
PubMed
Summary

Ophthalmoplegic migraine, a rare condition, was diagnosed in a young woman with recurrent headaches and right pupil dilation. Diagnostic tests, including brain imaging and angiography, were normal, but a tyramine eyedrop test indicated parasympathetic nerve dysfunction.

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Area of Science:

  • Neurology
  • Ophthalmology

Background:

  • Ophthalmoplegic migraine is a rare neurological disorder characterized by recurrent episodes of headache accompanied by cranial nerve palsies, typically affecting the oculomotor nerve.
  • This condition can be challenging to diagnose due to its episodic nature and the potential for overlapping symptoms with other headache disorders and neurological conditions.

Observation:

  • A young woman presented with recurrent headaches associated with unilateral mydriasis (pupil dilation) of the right eye.
  • Initial investigations, including computed tomography (CT) scan, magnetic resonance (MR) imaging of the brain, and selective cerebral angiography, did not reveal any abnormalities.
  • A positive response to tyramine eyedrops suggested parasympathetic hypofunction on the affected right side.

Findings:

  • The clinical presentation and diagnostic workup were consistent with ophthalmoplegic migraine.

Related Experiment Videos

  • The tyramine eyedrop test provided crucial evidence supporting parasympathetic nervous system dysfunction in the affected eye.

    • Implications:

    • This case highlights the importance of considering ophthalmoplegic migraine in patients with recurrent headaches and associated ocular motor nerve dysfunction, even with unremarkable neuroimaging.
    • The tyramine eyedrop test can be a valuable diagnostic tool for identifying parasympathetic hypofunction in suspected cases.
    • Accurate diagnosis is essential for appropriate management and to rule out more serious underlying pathologies.