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• Vol.43 No.6
• CLINICA NEUROL, 43: 356−359, 2003
• Vol.43 No.6 contents

Case Report

MRI abnormalities of the oculomotor nerve in a case of ophthalmoplegic migraine

Nobuya Fujita, M.D.¹⁾, Yuzuru Okuizumi, M.D.²⁾, Masayoshi Tada, M.D.¹⁾ and Hiroko Nagai, M.D.¹⁾

Departments of ¹⁾Neurology and ²⁾Radiology, Nagaoka Red Cross Hospital

A 15-year-old girl presented with headache in the left retro-orbital area associated with double vision. She had a history of migraine headaches since the age of 9, and her mother also had suffered from migraine. The patient had experienced a similar episode at the age of 13, which resolved without any treatment in a day. On examination, two days after the onset of diplopia the patient had left ptosis and paresis of inwards and downwards in the left eye. Her pupils were isocoric, and the light reflex was prompt. MRI of the brain showed thickening and enhancement of the left third nerve through the cistern portion, especially at the oculomotor midbrain exit. No cavernous sinus involvement was noted. Results of the hemogram, ESR, and CSF were normal. The oculomotor palsy resolved spontaneously within six days. A follow-up MRI two months later demonstrated a marked lessening of enhancement at the oculomotor nerve but did not completely disappeared. These serial MRI abnormalities are thought to be important and typical findings seen in the patients of ophthalmoplegic migraine.

(CLINICA NEUROL, 43: 356−359, 2003)
key words: ophthalmoplegic migraine, oculomotor nerve palsy, MRI

(Received: 28-Mar-03)