title: Neuromuscular hamartoma is a possible primary pathology of oculomotor ophthalmoplegic migraine.
abstract: BACKGROUND
  Oculomotor ophthalmoplegic migraine (O-OPM) occurs in many children, and in some cases MRI shows a small mass in the root exit zone (REZ) of the oculomotor nerve. This mass is considered to result from nerve hypertrophy caused by repeated demyelination.
  
  
  METHODS
  A 51-year-old man has been on oral medication for O-OPM, which he had from 6 years of age. However, the frequency and intensity of his migraine attacks have gradually increased. Brain magnetic resonance imaging (MRI) revealed a small nodular mass in the REZ of the oculomotor nerve. The mass was initially diagnosed as oculomotor schwannoma and tumor resection was attempted. However, as the mass was tightly adhered to the oculomotor nerve and hemorrhagic, biopsy was performed. The pathological diagnosis was neuromuscular hamartoma.
  
  
  CONCLUSIONS
  The small nodular mass in the REZ of the oculomotor nerve may be a hamartoma associated with congenital factors and may possibly be the primary pathology of O-OPM in this case.
authors.affiliation: Department of Neurosurgery, Tokyo Medical University, Japan.
authors.forename: Jiro
authors.initials: J
authors.lastname: Akimoto
authors.forename: Shinjiro
authors.initials: S
authors.lastname: Fukami
authors.forename: Ryo
authors.initials: R
authors.lastname: Hashimoto
authors.forename: Jo
authors.initials: J
authors.lastname: Haraoka
mesh_terms: D006222:Hamartoma / Q000150:complications* / Q000473:pathology / Q000601:surgery; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009442:Neurilemmoma / Q000150:complications* / Q000473:pathology / Q000601:surgery; D009802:Oculomotor Nerve / Q000473:pathology* / Q000601:surgery; D015840:Oculomotor Nerve Diseases / Q000150:complications* / Q000473:pathology / Q000601:surgery; D060486:Ophthalmoplegic Migraine / Q000209:etiology*