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 III^rd), with ipsilateral headache.

Diagnostic criteria:

1. At least two attacks fulfilling criterion B
2. Both of the following:
   1. unilateral headache
   2. ipsilateral paresis of one, two or all three ocular motor nerves¹
3. Orbital, parasellar or posterior fossa lesion has been excluded by appropriate investigation
4. 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.