Ophthalmoplegic migraine – Ophthalmology MCQ

Ophthalmoplegic migraine is best characterised as?
A. Recurrent headache with transient palsy of ophthalmic nerve
B. Headache associated with irreversible palsy of 3rd nerve
C. Recurrent headache with transient palsy of 3, 4 and / or 6th cranial nerves
D. Headache with optic neuritis

Correct answer : C. Recurrent headache with transient palsy of 3, 4 and / or 6th cranial nerves

Ophthalmoplegic migraine

• It is  a rare condition which was previously considered as a type of migraine.
• Recent studies suggest that is it likely to be an inflammatory cranial neuropathy.
• The International Headache Classification has reclassified ophthalmoplegic migraine as a type of neuralgia from its earlier classification as a type of migraine.
• It is characterised by transient migraine like headache associated with paresis of oculomotor, trochlear and/or abducens nerves.
• To arrive at a diagnosis of ophthalmoplegic migraine, other causes should be ruled out by appropriate investigations (like digital subtraction angiography / magnetic resonance angiography of the brain).

References:

• Levin M1, Ward TN. Ophthalmoplegic migraine. Curr Pain Headache Rep. 2004 Aug;8(4):306-9.