13.10 Recurrent painful ophthalmoplegic neuropathyHartmut Gobel2018-02-06T13:09:16+00:00
Previously used term:
Ophthalmoplegic migraine (this old and inappropriate term was rejected because this syndrome is not migrainous but rather a recurrent painful neuropathy).
Description:
Repeated attacks of paresis of one or more ocular cranial nerves (commonly the IIIrd), with ipsilateral headache.
Diagnostic criteria:
- At least two attacks fulfilling criterion B
- Both of the following:
- unilateral headache
- ipsilateral paresis of one, two or all three ocular motor nerves1
- Orbital, parasellar or posterior fossa lesion has been excluded by appropriate investigation
- Not better accounted for by another ICHD-3 diagnosis.
Note:
Some data suggest that headache can develop up to 14 days prior to ocular motor paresis.
Comments:
Gadolinium enhancement or nerve thickening can be demonstrated using MRI.
Treatment with corticosteroids is beneficial in some patients.