Ophthalmoplegic migraine and infundibular dilatation of a cerebral artery.
Ophthalmoplegic migraine (OM) is a childhood disorder of uncertain etiology manifesting recurrent unilateral headache associated with a transitory oculomotor (usually IIIrd nerve) palsy. Recent publications emphasize the finding on MRI of contrast enhancement in the IIIrd nerve suggesting that OM may be a recurrent inflammatory neuropathy. We report the case of a 7-year-old boy with typical symptoms of this disorder. Angio MR and Angio CT revealed the presence of an infundibular dilatation of a perforating branch of the posterior cerebral artery adjacent to the symptomatic IIIrd nerve. We speculate that this and perhaps other cases of OM may have a different pathophysiology related to compression of the IIIrd nerve by an adjacent vascular structure that could activate the trigeminovascular system and produce migrainous pain.
Vieira
José Pedro
JP
Castro
Jorge
J
Gomes
Leonor Bastos
LB
Jacinto
Sandra
S
Dias
Ana
A
D017668:Age of Onset; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D002539:Cerebral Arterial Diseases / Q000150:complications* / Q000000981:diagnostic imaging; D002648:Child; D002675:Child, Preschool; D004108:Dilatation, Pathologic / Q000150:complications; D005444:Flunarizine / Q000627:therapeutic use; D006801:Humans; D007223:Infant; D008279:Magnetic Resonance Imaging; D008297:Male; D008881:Migraine Disorders / Q000188:drug therapy / Q000209:etiology*; D015840:Oculomotor Nerve Diseases / Q000150:complications* / Q000000981:diagnostic imaging; D009886:Ophthalmoplegia / Q000000981:diagnostic imaging / Q000209:etiology*; D011241:Prednisone / Q000627:therapeutic use; D011859:Radiography; D014665:Vasodilator Agents / Q000627:therapeutic use
D000893:Anti-Inflammatory Agents; D014665:Vasodilator Agents; D005444:Flunarizine; D011241:Prednisone