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Ophthalmoplegic Migraine and Infundibular Dilatation of a Cerebral Artery

Authors

  • José Pedro Vieira,

    1. From the Hospital Dona Estefania—Neurology, Lisbon, Portugal (J. Vieira, S. Jacinto and A. Dias); Hospital Dona Estefania—Radiology, Lisbon, Portugal (J. Castro and L. Gomes).
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  • Jorge Castro,

    1. From the Hospital Dona Estefania—Neurology, Lisbon, Portugal (J. Vieira, S. Jacinto and A. Dias); Hospital Dona Estefania—Radiology, Lisbon, Portugal (J. Castro and L. Gomes).
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  • Leonor Bastos Gomes,

    1. From the Hospital Dona Estefania—Neurology, Lisbon, Portugal (J. Vieira, S. Jacinto and A. Dias); Hospital Dona Estefania—Radiology, Lisbon, Portugal (J. Castro and L. Gomes).
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  • Sandra Jacinto,

    1. From the Hospital Dona Estefania—Neurology, Lisbon, Portugal (J. Vieira, S. Jacinto and A. Dias); Hospital Dona Estefania—Radiology, Lisbon, Portugal (J. Castro and L. Gomes).
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  • Ana Dias

    1. From the Hospital Dona Estefania—Neurology, Lisbon, Portugal (J. Vieira, S. Jacinto and A. Dias); Hospital Dona Estefania—Radiology, Lisbon, Portugal (J. Castro and L. Gomes).
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  • Conflict of Interest: None

  • Clinical Notes

J. Vieira, Hospital Dona Estefania—Neurology, Lisbon, Portugal.

Abstract

Ophthalmoplegic migraine (OM) is a childhood disorder of uncertain etiology manifesting recurrent unilateral headache associated with a transitory oculomotor (usually IIIrd nerve) palsy. Recent publications emphasize the finding on MRI of contrast enhancement in the IIIrd nerve suggesting that OM may be a recurrent inflammatory neuropathy.

We report the case of a 7-year-old boy with typical symptoms of this disorder. Angio MR and Angio CT revealed the presence of an infundibular dilatation of a perforating branch of the posterior cerebral artery adjacent to the symptomatic IIIrd nerve. We speculate that this and perhaps other cases of OM may have a different pathophysiology related to compression of the IIIrd nerve by an adjacent vascular structure that could activate the trigeminovascular system and produce migrainous pain.

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