Ophthalmoplegic Migraine and Infundibular Dilatation of a Cerebral Artery

Vieira, JP; Castro, J; Gomes, LB; Jacinto, S; Dias, AI

http://hdl.handle.net/10400.17/2342

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Abstract(s)

Ophthalmoplegic migraine (OM) is a childhood disorder of uncertain etiology manifesting recurrent unilateral headache associated with a transitory oculomotor (usually IIIrd nerve) palsy. Recent publications emphasize the finding on MRI of contrast enhancement in the IIIrd nerve suggesting that OM may be a recurrent inflammatory neuropathy. We report the case of a 7-year-old boy with typical symptoms of this disorder. Angio MR and Angio CT revealed the presence of an infundibular dilatation of a perforating branch of the posterior cerebral artery adjacent to the symptomatic IIIrd nerve. We speculate that this and perhaps other cases of OM may have a different pathophysiology related to compression of the IIIrd nerve by an adjacent vascular structure that could activate the trigeminovascular system and produce migrainous pain.

Keywords

Cerebral Arterial Diseases/complications Cerebral Arterial Diseases/radiography Dilatation, Pathologic/complications Flunarizine/therapeutic use Migraine Disorders/drug therapy Migraine Disorders/etiology Oculomotor Nerve Diseases/complications Oculomotor Nerve Diseases/radiography Prednisone/therapeutic use Vasodilator Agents/therapeutic use Child HDE NEU PED