title: Ophthalmoplegic migraine: from questions to answers.
abstract: BACKGROUND
  The International Classification of Headache Disorders classifies ophthalmoplegic migraine (OM) under "cranial neuralgias and central causes of facial pain." OM is diagnosed when all the following criteria are satisfied: A. At least two attacks fulfilling criterion B. B. Migraine-like headache accompanied or followed within four days of its onset by paresis of one or more of the III, IV and/or VI cranial nerves. C. Parasellar orbital fissure and posterior fossa lesions ruled out by appropriate investigations. In children the syndrome is rare and magnetic resonance (MR) shows strongly enhancing thickened nerve at the root entry zone (REZ).
  
  
  METHODS
  The authors review the literature focusing on pathogenesis theories.
  
  
  RESULTS
  The authors suggest that ischemic reversible breakdown of the blood-nerve barrier is the most probable cause of OM and to include MR findings in the hallmarks of the disease.
  
  
  CONCLUSIONS
  OM is the same disease in adulthood and childhood, even if in adults the MR imaging findings are negative. In the authors' opinion, OM should be classified as migraine.
authors.affiliation: Department of Diagnostic Imaging, Villalba Hospital, GVM, Care and Research, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Ambrosetto
authors.affiliation: Department of Neurosurgery, IRCCS Istituto delle Scienze Neurologiche, Bologna, Italy francescanicolini@hotmail.it.
authors.forename: Francesca
authors.initials: F
authors.lastname: Nicolini
authors.affiliation: Department of Neurosurgery, IRCCS Istituto delle Scienze Neurologiche, Bologna, Italy.
authors.forename: Matteo
authors.initials: M
authors.lastname: Zoli
authors.affiliation: Department of Neuroradiology, IRCCS Istituto delle Scienze Neurologiche, Bologna, Italy Department of Experimental, Diagnostic and Speciality Medicine (DIMES), University of Bologna, Bologna, Italy.
authors.forename: Luigi
authors.initials: L
authors.lastname: Cirillo
authors.affiliation: Department of Radiology, Ospedale Santa Chiara, Trento, Italy.
authors.forename: Paola
authors.initials: P
authors.lastname: Feraco
authors.affiliation: Department of Neuroradiology, IRCCS Istituto delle Scienze Neurologiche, Bologna, Italy.
authors.forename: Antonella
authors.initials: A
authors.lastname: Bacci
mesh_terms: D000328:Adult; D002648:Child; D006801:Humans; D060486:Ophthalmoplegic Migraine / Q000145:classification* / Q000473:pathology* / Q000503:physiopathology*
keywords: Ophthalmoplegic migraine; cranial nerve palsy; headache; neuroradiology; pediatric