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SYNOPSIS

We report two children with isolated recurrent painless oculomotor palsy in whom neurodiagnostic investigations were normal. The tests included Edrophonium hydrochloride (Tensilon) testing and arteriography in one child. Single attacks were observed from onset to resolution in both children. A diagnosis of painless ophthalmoplegic migraine was suspected. Because permanent deficits in ocular motility are apt to occur following repeated attacks of ophthalmoplegic migraine, one child was placed on prophylactic therapy with propranalol. She later developed periodic headache with nausea despite treatment.