A contrast enhanced lesion of the III nerve on MR of a patient with ophthalmoplegic migraine as evidence for a Tolosa-Hunt syndrome.
A 23-year-old female with a six year history of migraine without aura twice developed a nearly complete internal and external III nerve paresis ipsilateral to her headache, two days after the onset of migraineous headache. An MR scan performed one week after the second episode showed a contrast enhanced lesion of the prepontine III nerve, where it enters the cavernous sinus on the left side. The headache, as well as the paresis ameliorated spontaneously. We suggest this is a further well documented case of "ophthalmoplegic migraine" which might reflect Tolosa-Hunt syndrome.
Straube
A
A
Department of Neurology, University of Munich, F.R.G.
Bandmann
O
O
Büttner
U
U
Schmidt
H
H
D000328:Adult; D001763:Blepharoptosis / Q000175:diagnosis; D002426:Cavernous Sinus / Q000473:pathology; D003287:Contrast Media; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D008279:Magnetic Resonance Imaging; D008881:Migraine Disorders / Q000175:diagnosis*; D009460:Neurologic Examination; D009802:Oculomotor Nerve / Q000473:pathology*; D015840:Oculomotor Nerve Diseases / Q000175:diagnosis*; D009886:Ophthalmoplegia / Q000175:diagnosis*; D009942:Organometallic Compounds; D004369:Pentetic Acid / Q000031:analogs & derivatives; D011149:Pons / Q000473:pathology
D003287:Contrast Media; D009942:Organometallic Compounds; D004369:Pentetic Acid; D019786:Gadolinium DTPA