title: Is migraine with cranial nerve palsy an ophthalmoplegic migraine?
abstract: Ophthalmoplegic migraine (OM) is a rare form of primary headache. Because of its rarity, only a few cases, mostly symptomatic, are reported. We analyse nine cases among 52 973 adults who suffer from headaches with an oculomotor palsy firstly considered as OM. The study was retrospective and multicentric in a database set up in France. The aim of our investigation was to describe the clinical and radiological aspects of these cases and to discuss the diagnosis of OM. We demonstrate that the characteristics of the headaches were identical to usual migraine without oculomotor nerve palsy for each case. The study emphasises the difficulty of the OM diagnosis even with the new IHS criteria because of the rarity of having all characteristics. A wide heterogeneity was noted in cranial imagery and blood tests. We suggest adding the code of probable OM in the IHS classification to increase the knowledge and detection of this type of headache. A biological blood test and an MRI are systematically required to help clinicians in their diagnosis and to exclude alternative aetiology of headache with palsy.
authors.affiliation: Service de Neurologie A, Centre Hospitalier de la région Annecienne, 1 Avenue du Tresum, F-74000, Annecy, France. pgiraud@ch-annecy.fr
authors.forename: Pierric
authors.initials: P
authors.lastname: Giraud
authors.forename: Dominique
authors.initials: D
authors.lastname: Valade
authors.forename: Michel
authors.initials: M
authors.lastname: Lanteri-Minet
authors.forename: Anne
authors.initials: A
authors.lastname: Donnet
authors.forename: Gilles
authors.initials: G
authors.lastname: Geraud
authors.forename: Evelyne
authors.initials: E
authors.lastname: Guégan-Massardier
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003389:Cranial Nerve Diseases / Q000150:complications*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D008881:Migraine Disorders / Q000150:complications*; D009886:Ophthalmoplegia / Q000209:etiology*; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods