Ophthalmoplegic Migraine

Abstract

A century has passed since the syndrome of recurrent attacks of headache and ophthalmoplegia was first described.¹The connection between such attacks and migraine was later established, and the term "ophthalmoplegic migraine" was coined.^2-7Since these early descriptions, a diverse number of conditions, including intracranial aneurysms, tumors of and about the third cranial nerve, basilar leptomeningitis, diabetes mellitus, and myasthenia gravis, have been shown to produce symptoms and signs similar to those seen in ophthalmoplegic migraine, and the existence of the syndrome as a separate clinical entity has been questioned. With the introduction of more refined neuroradiological methods, underlying structural defects may be more readily detected. Despite the use of these techniques, there remains a group of patients with recurrent headache and extraocular paralysis in whom no structural or metabolic abnormality can be detected. Among over 5,000 patients with migraine studied at the Neurological Institute and the Montefiore