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]
Gastrointestinal
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Vomiting
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]
One group, with Charcot, consider this clinical syndrome a common migraine complicated in some of its attacks with ophthalmoplegia; the other group, with Möbius, consider it a relapsing ophthalmoplegia accompanied with cephalalgia and vomiting, a condition [jamanetwork.com]
Symptoms Symptoms include: • Headache that is like a migraine • Sometimes the headache is absent • Cranial neuropathy involving the oculomotor nerves, resulting in paralysis of the eye • Decreased consciousness • Confusion • Vomiting • Seizures It can [empowher.com]
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Nausea
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]
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]
You may also have other symptoms, such as nausea and weakness. You may be sensitive to light and sound. Who gets migraines? About 12 percent of Americans get migraines. They can affect anyone, but you are more likely to have them if you Are a woman. [icdlist.com]
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]
The clinical picture of seizure headaches includes the following features: they are usually diffuse or bifrontal; they begin abruptly at any time and last for minutes or several hours; in the majority of cases they are accompanied by nausea and vomiting [books.google.com]
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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]
Skin
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Angioedema
Cicardi M, Aberer W, Banerji A, Bas M, Bernstein JA, et al. (2014) Classification, diagnosis, and approach to treatment for angioedema: consensus report from the Hereditary Angioedema International Working Group. Allergy 69:602-616. [omicsonline.org]
Eyes
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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]
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Photophobia
He also had vomiting and photophobia. Later the intensity of headache decreased and it became dun ache. He was admitted to a service hospital where clinical exam revealed partial ptosis. exotropia, weak adduction. supra and infraduction of left eye. [docksci.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]
[…] 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]
The headache may or may not have migrainous features; accompanied by photophobia, phonophobia, or nausea/vomiting. The ophthalmoplegia can occur immediately or up to 14 days after the headache. One or multiple nerves may be affected. [morancore.utah.edu]
Other research suggests that migraine photophobia is caused by melanopsin-containing retinal ganglion cells, which mediate light input. [mdedge.com]
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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]
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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]
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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]
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]
Mucocele of the sphenoidal sinus or tumors or inflammatory lesions that invade the cavernous sinus can cause painful ophthalmoplegia. [pediatricneurosciences.com]
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]
Neurologic
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Headache
Abstract Ophthalmoplegic migraine (OM) is a rare form of primary headache. Because of its rarity, only a few cases, mostly symptomatic, are reported. [ncbi.nlm.nih.gov]
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Vertigo
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]
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]
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]
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Dizziness
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 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]
Basilar migraine Basilar migraine, also known as Bickerstaff syndrome, typically causes dizziness and vertigo prior to a headache. [healthline.com]
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]
The onset of the headache may be associated with temporary numbness, dizziness or vision changes. Retinal migraine. [my.clevelandclinic.org]
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Areflexia
Each patients had dysphagia, areflexia, sensory loss, and weakness of all four limbs, which in two was asymmetrical. [scinapse.io]
ADEM and Miller-Fischer syndrome can present as third nerve palsies but they would also tend to be accompanied by other neurologic deficits such as ataxia or areflexia. [morancore.utah.edu]
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Polyradiculoneuropathy
We present 3 patients with chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) with extensive and diffuse hypertrophy of the nerve roots and peripheral nerves. [scinapse.io]
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]
MR
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Brain MRI Abnormal
Migralepsy (migraine-triggered seizures) is the term used when a seizure occurs during or within 1 hour of a typical migraine aura attack. [72] Reversible brain MRI abnormalities have been reported in a patient with migraine-triggered seizure, possibly [emedicine.medscape.com]
HLA Type
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HLA-B27
All of them were HLA-B27 positive whereas one healthy sibling was HLA-B27 negative. [ncbi.nlm.nih.gov]
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]
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]
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]
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]
Epidemiology
Thus major advances in headache epidemiology may be expected to occur when migraine is defined by a laboratory finding'. [books.google.com]
Descriptive epidemiology of epilepsy: contributions of population-based studies from Rochester, Minnesota. Mayo Clin Proc 1996; 71:576-586. PMid:8642887 Headache Classification Subcommittee of the International Headache Society. [smartscitech.com]
Epidemiology OM/RPON is a rare condition with a prevalence of 0.7 per million6; it usually begins in childhood.2,3 A systematic review authored by Gelfand found a median age of onset at 8 years old (interquartile range 3, 16). [morancore.utah.edu]
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]
Pathophysiology
The possible pathophysiology of this unique finding is discussed. [ncbi.nlm.nih.gov]
Prevention
Early high-dose corticosteroid treatment is recommended to rapidly resolve an acute episode and to potentially prevent permanent abnormal oculomotor nerve signs. [ncbi.nlm.nih.gov]
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. [jstage.jst.go.jp]
Prevention of death, myocardial infarction, and stroke by prolonged antiplatelet therapy in various categories of patients. [books.google.com]