title: Bilateral ophthalmoplegia in a child with migraine.
abstract: BACKGROUND
  In children, migraine with or without aura is a common entity, however variants like recurrent painful optic neuropathy (RPON) is rarely encountered.
  
  
  METHODS
  A 9 year old boy presented with headache for 1 week and restricted movements and drooping in both eyes for last 3 days. On examination he had bilateral ophthalmoplegia and ptosis. History of migrainous headache was present in the patient as well as his mother. His MRI brain with venogram, serum autoimmune markers, serum and urine toxicology screen and repetitive nerve stimulation test were normal. He received intravenous pulse followed by oral steroids for 6 weeks and was started on antimigraine prophylaxis. Eighteen months since the attack, he has improved completely with mild asymmetric mydriasis persisting.
  
  
  CONCLUSIONS
  This may represent first attack of RPON in a child with migraine. Rarely this may herald the onset of migraine as well, index of suspicion should be high as it is a diagnosis of exclusion and a treatable entity.
authors.affiliation: Division of Child Neurology, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi 110029, India.
authors.forename: Rachana
authors.initials: R
authors.lastname: Dubey
authors.affiliation: Division of Child Neurology, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi 110029, India.
authors.forename: Biswaroop
authors.initials: B
authors.lastname: Chakrabarty
authors.affiliation: Division of Child Neurology, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi 110029, India.
authors.forename: Lokesh
authors.initials: L
authors.lastname: Saini
authors.affiliation: Division of Child Neurology, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi 110029, India.
authors.forename: Priyanka
authors.initials: P
authors.lastname: Madaan
authors.affiliation: Division of Child Neurology, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi 110029, India. Electronic address: sheffaligulati@gmail.com.
authors.forename: Sheffali
authors.initials: S
authors.lastname: Gulati
mesh_terms: D002648:Child; D004827:Epilepsy; D006261:Headache; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008881:Migraine Disorders / Q000209:etiology / Q000628:therapy; D009886:Ophthalmoplegia / Q000209:etiology* / Q000628:therapy*; D009901:Optic Nerve Diseases / Q000628:therapy*; D010146:Pain; D010523:Peripheral Nervous System Diseases; D013256:Steroids / Q000627:therapeutic use
chemical_list: D013256:Steroids
keywords: Migraine; Ophthalmoplegia; RPON; Steroids; Treatable