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Query: UMLS:C0029089 (ophthalmoplegia)
 3,338 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The authors begin by enumerating the various syndromes in which painful ophthalmoplegia may be observed (sphenoidal fissure syndrome, Collier's syndrome, syndromes involving the orbital apex, the cavernous sinus and parasellar syndromes; Raeder's syndrome, Gradenigo's syndrome and Fischer-Brugge syndrome). They then discuss the various causes that must be investigated in all cases of painful ophtalmoplegia. They consider in order: -- ophtalmoplegia due to general causes (especially diabetes) and neurological causes (e.g. multiple sclerosis); -- ophtalmoplegia due to common local canses space-occupying processes, vascular malformations, ear, nose and larynx infections); -- painful ophalmoplegia of unknown origin, which includes four entities of very differing importance (Gubler and Charcot's ophthalmoplegic migraine and Tolosa-Hunt syndrome of which the clinical symptoms and course are so different that they can be distinguished as two entities; and, secondarily, inflammatory pseudo-tumours of the orbit and the recurrent multiple cranial nerve palsies that are observed in South-East Asia). (Acta nurol. belg., 1977, 77, 331-350).
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PMID:[Painful ophthalmoplegia (author's transl)]. 2 45

Migraine is classified into four basic categories: common, classic, cluster, and complicated. Ocular migraine is a periodic loss of vision in one eye typically lasting 30 minutes or less. Ophthalmoplegia is a severe ipsilateral hemicranial headache that is preceded by aura of lightning flashes and expanding circles of light, accompanied by temporary ocular motor nerve palsies.
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PMID:Vision and migraine. 178 28

We report a 14-year-old girl who presented with yearly attacks of bilateral internal ophthalmoplegia, nausea and headache, since the age of nine. The episodic isolated bilateral mydriasis in this child is believed to be a migraine equivalent.
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PMID:Bilateral episodic mydriasis as a migraine equivalent in childhood: a case report. 188 77

Charts from patients admitted from April 1976 to March 1986 to the departments of neurology, neurosurgery, ophthalmology and pediatrics serving a population of 615,000 inhabitants in Copenhagen County were surveyed. We then examined patients with coexisting headache and ophthalmoplegia at follow-up. Many diseases may mimic a single attack of ophthalmoplegic migraine. We found 4 cases of ophthalmoplegic migraine, i.e. an annual incidence of 0.7 per million inhabitants. We added another 4 cases from the same area, but diagnosed before or after the study period. Only in 2 of the 8 cases did the ophthalmoplegic episodes fulfil criteria for pain and associated symptoms required for migraine without aura (common migraine). In contrast, the clinical characteristics of the attacks are typical of the Tolosa-Hunt syndrome. When this inflammatory disease strikes a migraineur it is likely to elicit headache with migrainous features. We postulate that such cases have been diagnosed as ophthalmoplegic migraine, whereas the proper diagnosis of Tolosa-Hunt syndrome has been made in non-migraineurs.
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PMID:Ophthalmoplegic migraine: diagnostic criteria, incidence of hospitalization and possible etiology. 233 Aug 16

A case of ophthalmoplegic migraine with cerebral aneurysm is reported. A 47-year-old female with a 17-year history of migraine was admitted. She had three attacks of severe migrainous headache accompanied with nausea and vomiting within three weeks. Soon after the third attack, she noticed diplopia and left blepharoptosis. Lumbar puncture revealed no hemorrhage but the cerebral angiogram demonstrated an aneurysm at the junction of the left internal carotid artery and the posterior communicating artery. Operation revealed that the oculomotor nerve was not compressed by the aneurysm. But the oculomotor nerve had an indentation produced by the posterior communicating artery at 1-2 mm distal to the midbrain. A piece of sponge was then inserted between the nerve and the responsible artery. After the operation, her oculomotor nerve palsy was gradually improved and she discharged with mild anisocoria. The exact pathogenesis of ophthalmoplegia in ophthalmoplegic migraine is still unknown. In our case, cross compression of the oculomotor nerve with dilated posterior communicating artery seemed to be the cause of ophthalmoplegia.
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PMID:[A case of ophthalmoplegic migraine with cerebral aneurysm]. 339 4

Among the painful ophthalmoplegias, ophthalmoplegic migraine and Tolosa-Hunt syndrome share many features. Our 6-year-old patient had three episodes of ophthalmoplegia. Two episodes were painful and promptly resolved with oral prednisone. She had no evidence of parasellar or systemic disease. A review of published cases of ophthalmoplegic migraine demonstrated that the clinical history, the cornerstone of diagnosis in migraine, does not differentiate ophthalmoplegic migraine from Tolosa-Hunt syndrome. Other features helpful in the diagnosis of Tolosa-Hunt syndrome were not usually investigated in reports of ophthalmoplegic migraine. Until better criteria are available for differentiating the two entities, we suggest that children who fulfill the clinical criteria for Tolosa-Hunt syndrome receive a trial of steroid therapy.
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PMID:Steroid-responsive ophthalmoplegia in a child. Diagnostic considerations. 400 4

Among 123 Nigerians with migraine seen at one clinic 49 (40%) had complicated migraine, with ophthalmoplegia in 20 and amaurosis or field defects in 13. Haemoglobin AS was found in 60% of patients with complicated migraine, compared with 20% of those with simple migraine.
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PMID:Complicated migraine and Haemoglobin AS in Nigerians. 503 86

Painful ophthalmoplegia occurred in a twelve-year-old boy, with repeated attacks over five years. This fits the description of Tolosa-Hunt syndrome which has only infrequently been described in children. Tolosa-Hunt syndrome combines severe lasting orbital pain and paralysis of one or more oculomotor nerves (extrinsic or intrinsic III, IV, VI). Pain is dramatically alleviated by high doses of corticosteroids, while the ophthalmoplegia improves more slowly. For some authors, this effect of corticosteroids is diagnostic. Repeated attacks occur over several years and resolve spontaneously with or without sequellae. Diagnosis can only be ascertained after careful ruling out of a general or locoregional etiology through clinical and paraclinical investigations. Differential diagnosis with ophthalmoplegic migraine may be difficult.
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PMID:[Painful Tolosa-Hunt ophthalmoplegia. Apropos of a case in a child]. 630 8

Visual and oculomotor changes may be the only abnormalities in patients complaining of headache. Ocular signs are common during episodes of migraine and cluster headache. Temporal arteritis may be an extracranial cause of ocular signs. Intracranial disorders include painful ophthalmoplegia, pseudotumor cerebri and various causes of increased intracranial pressure. Neurophthalmologic evaluation in headache patients must include assessment of visual acuity and visual fields, examination of pupils (including pharmacologic testing), ophthalmoscopic examination and auscultation for bruits.
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PMID:Neurophthalmologic signs in headache syndromes. 706 59

Migraine can be associated with hemiplegia, ophthalmoplegia, retinal and vertebrobasilar insufficiency, amnesia, confusion, altered perception, stupor and even death. Migrainous complications must be differentiated from structural lesions, metabolic disorders, convulsive states are cerebrovascular thromboembolism. Treatment of complicated migraine is directed toward prophylaxis of vasoconstriction. Agents that produce vasoconstriction, such as ergot preparations, and known migraine precipitants should be avoided in migraineurs.
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PMID:Neurologic complications of migraine. 712 78


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