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The Journal of Headache and Pain logoLink to The Journal of Headache and Pain
. 2007 May 11;8(2):119–122. doi: 10.1007/s10194-007-0371-1

Is migraine with cranial nerve palsy an ophthalmoplegic migraine?

Pierric Giraud 1,, Dominique Valade 2, Michel Lanteri-Minet 3, Anne Donnet 4, Gilles Geraud 5, Evelyne Guégan-Massardier 6; and the Observatoire des Migraines et Céphalées of the French Headache Society
PMCID: PMC3476125  PMID: 17497265

Abstract

Ophthalmoplegic migraine (OM) is a rare form of primary headache. Because of its rarity, only a few cases, mostly symptomatic, are reported. We analyse nine cases among 52 973 adults who suffer from headaches with an oculomotor palsy firstly considered as OM. The study was retrospective and multicentric in a database set up in France. The aim of our investigation was to describe the clinical and radiological aspects of these cases and to discuss the diagnosis of OM. We demonstrate that the characteristics of the headaches were identical to usual migraine without oculomotor nerve palsy for each case. The study emphasises the difficulty of the OM diagnosis even with the new IHS criteria because of the rarity of having all characateristics. A wide heterogeneity was noted in cranial imagery and blood tests. We suggest adding the code of probable OM in the IHS classification to increase the knowledge and detection of this type of headache. A biological blood test and an MRI are systematically required to help clinicians in their diagnosis and to exclude alternative aetiology of headache with palsy.

Keywords: Ophtalmoplegic migraine, Cranial nerve palsy, Migraine and ocular palsy

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