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SYNOPSIS

We describe a 61-year-old woman with unilateral ophthalmoplegia with migraine type headache. Pathological examination revealed severe atrophy of the third cranial nerve as the result of vascular compression by the atheromatous posterior cerebral artery. Although the exact pathogenesis of ophthalmoplegic migraine (OM) is uncertain at the present time, this unique case with clinical and pathological observations suggests that vascular compression and the resulting ischemia of the third cranial nerve can closely simulate OM.