Presentation
In both cases, enhancement and thickening of the cisternal segment of the oculomotor nerve were present at initial presentation. Ophthalmoplegia resolved spontaneously in 1 child and after steroid treatment in the other. [ncbi.nlm.nih.gov]
Entire Body System
- Epilepsy
Juvenile myoclonic epilepsy: epidemiology, pathophysiology, and management. [smartscitech.com]
EFHC1 Epilepsy, juvenile absence, Epilepsy, myoclonic juvenile, Epilepsy, severe intractable GABRA1 Epilepsy, childhood absence, Epilepsy, juvenile myoclonic, Epileptic encephalopathy, early infantile GABRB3 Epilepsy, childhood absence GABRG2 Dravet syndrome [genda.com.ar]
Do the epilepsies, pain syndromes, and affective disorders share common kindling-like mechanisms? Epilepsy Research, 2002, vol. 50, p. 203-219 [BIUM Call Number 115.889] POST (Robert M.), SILBERSTEIN (Stephen D.). [biusante.parisdescartes.fr]
Progress also has been made in treatment of migraine, stroke, epilepsy, multiple sclerosis, traumatic brain injury, and pain. [dictionary.cambridge.org]
Antimigren-Zdorovye it is necessary to appoint with care the patient with epilepsy or with other forms of a convulsive syndrome (including in the anamnesis); to patients with controlled arterial hypertension because of danger of tranzitorny increase in [en.medicalmed.de]
- Severe Pain
Migraines range greatly in severity. When a migraine is mild, the pain may be nothing more than an annoyance. When a migraine is severe, it can inhibit your focus and concentration and at certain times, you might find it hard to do your job at work. [migrainescenter.org]
Migraines are recurring attacks of moderate to severe pain. The pain is throbbing or pulsing, and is often on one side of the head. During migraines, people are very sensitive to light and sound. They may also become nauseated and vomit. [fpnotebook.com]
Headache has at least two of the following characteristics Unilateral location Pulsating quality Moderate or severe pain intensity Aggravation by or causing avoidance of routine physical activity D. [migraine.ie]
More than 14 percent of adults in the United States are affected by migraines, severe pain in the head that is sometimes accompanied by vision problems, nausea, vomiting, and dizziness. [healthline.com]
Gastrointestinal
- Vomiting
History 38 yo nurse Previous medical history unremarkable –ruptured ovarian cysts 1997 und 2000 –gastritis 18 years ago –history of migrene 1-2 ictus/year Present clinical presentation increasing left frontal headache initially retrobulbar acute nausea, vomiting [ismrmforms.org]
And the headache had couple of features similar to that of migraine, such as past history of recurrent migraine attacks, accompaniments of nausea, vomiting, and phonophobia, response to flunarizine and sodium valproate. [ncbi.nlm.nih.gov]
G43.A0 Cyclical vomiting, not intractable G43.A1 Cyclical vomiting, intractable G43.B Ophthalmoplegic migraine G43.B1 Ophthalmoplegic migraine, intractable G43.C Periodic headache syndromes in child or adult G43.C0 Periodic headache syndromes in child [healthprovidersdata.com]
G43.A0 Cyclical vomiting, not intractable Inclusion term(s): Cyclical vomiting, without refractory migraine G43.A1 Cyclical vomiting, intractable Inclusion term(s): Cyclical vomiting, with refractory migraine G43.B Ophthalmoplegic migraine G43.B0 Ophthalmoplegic [icd10coded.com]
NIH: National Institute of Neurological Disorders and Stroke Definition (NCI) A common, severe type of vascular headache often associated with increased sympathetic activity, resulting in nausea, vomiting, and light sensitivity. [fpnotebook.com]
- Nausea
Medical History 38 yo nurse Previous medical history unremarkable –ruptured ovarian cysts 1997 und 2000 –gastritis 18 years ago –history of migrene 1-2 ictus/year Present clinical presentation increasing left frontal headache initially retrobulbar acute nausea [ismrmforms.org]
And the headache had couple of features similar to that of migraine, such as past history of recurrent migraine attacks, accompaniments of nausea, vomiting, and phonophobia, response to flunarizine and sodium valproate. [ncbi.nlm.nih.gov]
Nausea, vomiting, and sensitivity to light (photophobia) often accompany migraine without aura. Abdominal migraine is most common in children with a family history of migraine. [healthcommunities.com]
He has had classic migraine headaches with photophobia and nausea for many years. Medications: Acetaminophen, as needed, with no relief of symptoms. [webeye.ophth.uiowa.edu]
Symptoms generally last one to 72 hours and include nausea, vomiting, and flushing. [healthline.com]
- Loss of Appetite
Sensitivity to light, noise and odors Nausea and vomiting, stomach upset, abdominal pain Loss of appetite Feeling very warm (sweating) or cold (chills) Pale color (pallor) Feeling tired Dizziness Blurred vision Tender scalp Diarrhea (rare) Fever (rare [my.clevelandclinic.org]
Repeated attacks of headache Moderately or severely painful Frequent or infrequent Last a few hours to a couple of days Often only one side of the head hurts Often experience loss of appetite, nausea, and vomiting World Federation of Neurology 3 [slideshare.net]
- Muscle Rigidity
[…] atrophy筋収縮[症] muscle cramp筋けいれん muscle rigidity筋硬直、筋硬度 muscle tone筋緊張 muscular atrophy筋萎縮[症] myasthenia gravis (MG)重症筋無力症 myasthenic crisis筋無力症クリーゼ myelitis脊髄炎 myelopathyミエロパチ(シ)ー myoclonusミオクロ[ー]ヌス、筋クロ[ー]ヌス、筋間代 myopathyミオパチ(シ)ー、筋障害、筋疾患 myotoniaミオトニー [tokyo-med.ac.jp]
Musculoskeletal
- Myalgia
Systemic symptoms like myalgia, fever, malaise or weight loss. Described as the worst headache of the patient's life, especially if it was rapid in onset. [patient.info]
The clinical picture may include: (1) polymyalgia rheumatica - malaise, loss of energy, proximal joint pains, and myalgias; (2) nonspecific headaches, sometimes associated with tenderness and swelling over the temporal or occipital arteries; and (3) evidence [dartmouth.edu]
Eyes
- Photophobia
[…] nurse Previous medical history unremarkable –ruptured ovarian cysts 1997 und 2000 –gastritis 18 years ago –history of migrene 1-2 ictus/year Present clinical presentation increasing left frontal headache initially retrobulbar acute nausea, vomiting, photophobia [ismrmforms.org]
Other research suggests that migraine photophobia is caused by melanopsin-containing retinal ganglion cells, which mediate light input. [mdedge.com]
Case report: An 18-year-old female refers photophobia, phonophobia and an intense pulsating headache over the entire head. Her pupils did not react to light and showed loss of accommodation. Fundus evaluation showed papilledema in the right eye. [anahuac.mx]
He has had classic migraine headaches with photophobia and nausea for many years. Medications: Acetaminophen, as needed, with no relief of symptoms. [webeye.ophth.uiowa.edu]
[…] known as hemicrania simplex) is a specific neurological disorder characterized by recurrent, throbbing headaches that often affect one side of the head (i.e., it is unilateral), are of at least moderate intensity, and may cause nausea, phonophobia or photophobia [diki.pl]
- Diplopia
Both had had previous shorter episodes of diplopia following migraine-like headaches. One recovered following an injection of botulinum toxin to the medial rectus of her affected eye 11 months after the onset of diplopia. [ncbi.nlm.nih.gov]
30-year-old male with migraine headaches and occasional diplopia March 7, 2005 Chief Complaint: 30-year-old male presents with a history of migraine headaches associated on two occasions with diplopia lasting for 2-4 weeks. [webeye.ophth.uiowa.edu]
- Scotoma
Visual migraines result from cortical spreading depression and are also commonly termed scintillating scotoma. [en.wikipedia.org]
Symptoms When ocular migraine appears, photopsy (visual aura), as well as scintillating scotoma. What is it? We explain that scotomas are blind spots in the field of vision. [en.triandgo.com]
Scintillating scotoma was consistently absent. This attack lasted for about a week and recurred every few months. [webview.isho.jp]
Most common premonitory symptoms are visual: Scotomas in central portion of visual field Hallucinations Fortification spectrum (paracentral scotoma which expands into a “C” shape with luminous angles at the enlarging outer border) 16. 1 Migraine originates [slideshare.net]
The patient may be aware of a dark spot (positive scotoma); or he/she may not be aware of the blank spot, bump into objects, or have the impression that objects disappear (negative scotoma). [biusante.parisdescartes.fr]
- Painful Ophthalmoplegia
Recurrent painful ophthalmoplegia started in infancy in two cases, childhood in two instances and adult life in one. One child had his first attacks at 3, 5 and 12 months of age, on each occasion 10 days after an injection of triple vaccine. [ncbi.nlm.nih.gov]
Cephalalgia 6:59–63 CrossRef PubMed CAS Google Scholar Mathew NT, Chandy J (1970) Painful ophthalmoplegia. [link.springer.com]
The original observ... more We present two patients with recurrent painful ophthalmoplegia starting in early childhood. Clinically, both patients fulfilled the criteria for ophthalmoplegic migraine. [scinapse.io]
Clinicopathological correlation in a case of painful ophthalmoplegia: Tolosa-Hunt syndrome. J Neurol Neurosurg Psychiat 1989; 52:1290–3. Hannerz J. Pain characteristics of painful ophthalmoplegia (the Tolosa-Hunt syndrome). [yumpu.com]
Painful ophthalmoplegia: an unresolved clinical problem. [eanpages.org]
- Scintillating Scotoma
Visual migraines result from cortical spreading depression and are also commonly termed scintillating scotoma. [en.wikipedia.org]
Symptoms When ocular migraine appears, photopsy (visual aura), as well as scintillating scotoma. What is it? We explain that scotomas are blind spots in the field of vision. [en.triandgo.com]
Scintillating scotoma was consistently absent. This attack lasted for about a week and recurred every few months. [webview.isho.jp]
Most auras are visual and are described as bright shimmering lights around objects or at the edges of the field of vision (called scintillating scotomas) or zigzag lines, castles (teichopsia), wavy images or hallucinations. [healthcommunities.com]
The most common aura is visual, which is commonly experienced as a central zig-zag figure traveling into the peripheral vision, transforming into an angulated shape with a scintillating edge (the “scintillating scotoma”). [aao.org]
Psychiatrical
- Auditory Hallucination
[…] spots) • Teichopsia/fortification spectra (luminous appearance before the eyes) • Photopsia (flashing lights) • Homonymous visual disturbance • Unilateral paresthesias/numbness • Unilateral weakness • Aphasia/unclassifiable speech difficulty • Visual or auditory [ahcmedia.com]
Neurologic
- Headache
It is unlikely that OM is a variant of migraine, since the headache often lasts for a week or more and there is a latent period of up to 4 days from the onset of headache to the onset of ophthalmoplegia. [ncbi.nlm.nih.gov]
- Paresis
Both the oculomotor paresis and concurrent presence of a deficiency of the near triad localized the vascular insult to the oculomotor nerve complex in the brainstem. [ncbi.nlm.nih.gov]
[…] ruptured ovarian cysts 1997 und 2000 –gastritis 18 years ago –history of migrene 1-2 ictus/year Present clinical presentation increasing left frontal headache initially retrobulbar acute nausea, vomiting, photophobia, phonophobia Left external oculomotor paresis [ismrmforms.org]
- Dizziness
Basilar Migraine This usually causes dizziness and vertigo before the headache. However, it may also cause loss of coordination, ringing in ears or speech problems. It mimics a stroke. [migrainescenter.org]
Arachnoid cysts of the cranial posterior fossa may produce symptoms tpical of a tumour such as headache dizziness Results of a complete physical head and neck examination were normal. [11let.eu]
I get my other traditional migraine symptoms; occasional nausea, a sense of unreality, spaciness, phantom scents, dizziness, sensitivity to light, a "tight" feeling beforehand and a "loose, floating" feeling after. [forums.intpcomplex.com]
Basilar migraine Basilar migraine, also known as Bickerstaff syndrome, typically causes dizziness and vertigo prior to a headache. [healthline.com]
The onset of the headache may be associated with temporary numbness, dizziness or vision changes. Retinal migraine. [my.clevelandclinic.org]
- Vertigo
Vertigo is a common complaint for many people with migraine, but frequent and recurring episodes of vertigo may be caused by a problem in the lower part of the brain. [healthline.com]
Vertebrobasilar Migraine A vertebrobasilar or vertiginous migraine is preceded by dizziness or vertigo. It is important to note that frequent and recurrent periods of vertigo may be caused by an issue in the lower part of the brain. [migrainescenter.org]
Symptoms include severe headache, vertigo, double vision, slurred speech and poor muscle coordination. This type occurs primarily in young people. [healthcommunities.com]
Benign paroxysmal vertigo of childhood Benign paroxysmal vertigo of childhood (BPVC) is characterized by brief episodes of vertigo and disequilibrium lasting for hours, without headache, aura, hearing loss, or tinnitus. [emedicine.medscape.com]
- Slurred Speech
Any neurologic problems associated with TIAs, such as weakness in one arm and slurred speech, are resolved within 24 hours. [dummies.com]
Symptoms include severe headache, vertigo, double vision, slurred speech and poor muscle coordination. This type occurs primarily in young people. [healthcommunities.com]
However, this migraine variant may also cause ringing in the ears, slurred speech, loss of balance, syncope, and even loss of consciousness prior to a headache. [healthline.com]
Typical symptoms include: pressure around the eyes (like a vice is crushing them), confusion, tingling of the facial skin, and slurred speech. [migrainesavvy.com]
This migraine is accompanied by vertigo, slurred speech, double vision or loss of balance, which occur before the headache. The headache pain may affect the back of the head. [my.clevelandclinic.org]
Workup
MRI of the brain post enhancement is a useful adjunct in the diagnosis and treatment of ophthalmoplegic migraine and should be considered as part of a workup of ophthalmoplegic migraine in children. [ncbi.nlm.nih.gov]
Discussion The differential diagnoses and workup of an isolated sixth nerve palsy usually depends on the age and the clinical circumstances of the patient. [dovepress.com]
The cerebral MRI, left temporal artery biopsy and blood workup at the time were unremarkable apart from a hypercholesterolemia. [eanpages.org]
Gastroenterologic evaluation and workup typically yield unremarkable results. [48] Abdominal migraine symptoms are usually relieved with sleep. Antiemetics may help in aborting an acute attack. [emedicine.medscape.com]
Treatment
Ophthalmoplegia resolved spontaneously in 1 child and after steroid treatment in the other. Both postresolution MRIs demonstrated decrease in enhancement and thickening of the third nerve. [ncbi.nlm.nih.gov]
Thorough coverage for each neurological disease clearly defines age at onset, course of illness, clinical features, and treatment options. Differential diagnosis tables and treatment algorithms expedite clinical decision making. [books.google.com]
Prognosis
This critical review provides a summary of the clinical presentation, neuroimaging, treatment and prognosis in pediatric ophthalmoplegic migraine (OM). The features of OM are not in keeping with its classification as a migraine-variant. [ncbi.nlm.nih.gov]
Medicines used to treat retinal migraines include aspirin, other NSAIDS, and medicines that reduce high blood pressure. [4] Prognosis [ edit ] In general, the prognosis for retinal migraine is similar to that of migraine headache with typical aura. [en.wikipedia.org]
Yet the effects were either unclear, not beneficial or even harmful in 35%, 8%, and 4% respectively.4 Prognosis: Prognosis in OM/RPON is generally excellent and most patients can experience a full recovery in days to weeks. [morancore.utah.edu]
The prognosis is favourable unless very frequent attacks occur. Palsies of other cranial nerves like trochlear, abducens and first division of trigeminal nerve have been described [6]. REFERENCES I. Robertson WC Jr. Schnintzler ER. [docksci.com]
Etiology
The etiology remains unclear, but may involve recurrent bouts of demyelination of the oculomotor nerve. "Ophthalmoplegic migraine" is a misnomer in that it is probably not a variant of migraine but rather a recurrent cranial neuralgia. [ncbi.nlm.nih.gov]
Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology. [icd10coded.com]
Although migraine or neuropathy have been suggested as etiologies, the precise etiology remains unclear. [jstage.jst.go.jp]
Epidemiology
Thus major advances in headache epidemiology may be expected to occur when migraine is defined by a laboratory finding'. [books.google.com]
Juvenile myoclonic epilepsy: epidemiology, pathophysiology, and management. [smartscitech.com]
Epidemiology and genetics of cluster headache. Lancet Neurol. 2004;3(5):279-283. 24. Mitsikostas DD, Edvinsson L, Jensen RH, et al. [midolordecabeza.org]
An epidemiological survey of hemiplegic migraine. Cephalalgia 2002; 22: 361-375. 40. [psjd.icm.edu.pl]
A genetic epidemiological study. Cephalalgia 1996;16:431-5. [ihs-klassifikation.de]
Pathophysiology
Implications from this finding are discussed in relation to the pathophysiology of ophthalmoplegic migraine. [ncbi.nlm.nih.gov]
Prevention
Certain natural treatments, such as riboflavin (vitamin B2) and coenzyme Q10, may help prevent migraines. If your magnesium level is low, you can try taking magnesium. There is also an herb, butterbur, which some people take to prevent migraines. [icdlist.com]
Thus, medication for migraine prophylaxis might be needed to prevent RPON. KEYWORDS: headache; migraine; mydriasis; oculomotor palsy; ophthalmoplegic migraine; recurrent painful ophthalmoplegic neuropathy [ncbi.nlm.nih.gov]
Thus, medication for migraine prophylaxis might be needed to prevent RPON. [jstage.jst.go.jp]
Experts don't know if medications that prevent migraines -- such as tricyclic antidepressants or anti-seizure medications -- can help prevent that vision loss. [webmd.com]