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         Ophthalmoplegic Migraine:     more detail

1. Diseases And Conditions -- Discovery Health -- Ophthalmoplegic Migraine
A short FAQ on ophthalmoplegic migraine.Category Health Conditions and Diseases Migraine Ophthalmoplegic......ophthalmoplegic migraine is a rare form of migraine headache that isfelt around the eye. ophthalmoplegic migraine By Terry Mason, MPH.
http://health.discovery.com/diseasesandcond/encyclopedia/3138.html
ophthalmoplegic migraine By Terry Mason, MPH Ophthalmoplegic migraine is a rare form of migraine headache that is felt around the eye. It is often connected with weakness of the muscles around the eye. What is going on in the body? An ophthalmoplegic migraine causes severe headache . It also may affect the person's vision. The process that causes this type of migraine is not well understood. One possible cause is inflammation of the blood vessels around the eye. Allergic reactions are another possible cause. What are the signs and symptoms of the condition? A person who has ophthalmoplegic migraine has specific symptoms involving the eyes. These symptoms may differ from person to person but most likely include the following: double vision droopy eyelid, known as ptosis eye paralysis other types of vision changes severe headache pain What are the causes and risks of the condition? A migraine occurs when cells in the brain become overly sensitive to stimulation. This type of migraine may start with an allergic reaction. Or it may begin with inflammation of the blood vessels around the eye. Factors that may trigger a migraine are as follows: alcohol certain foods, including chocolate and some cheeses

2. Poster37.htm
Brief argument that magnetic resonance imaging (MRI) of the brain may be helpful in the diagnosis ophthalmoplegic migraine in children.
http://med-aapos.bu.edu/pappostp5/poster37.htm
MR Imaging in Ophthalmoplegic Migraine of Children
Mary A. O'Hara, M.D., Robert T. Anderson, M.D., Douglas Brown, M.D.
Ophthalmoplegic migraine is a rare finding in childhood. Clinical history may not be characteristic and there is some overlap in symptoms with Tolosa-Hunt syndrome. Magnetic resonance imaging (MRI) of the brain may be helpful in the diagnosis. Methods : Magnetic resonance imaging of the brain was performed on two children during recurrent attacks of ophthalmoplegia. A seven year old girl presented with her second episode of headache and unilateral third nerve palsy. A three year old boy presented with his third episode of nausea/vomiting followed by unilateral complete CN III paresis. Results : In both cases, MRI of the brain enhanced with Gd-DTPA demonstrated ipsilateral enhancement of the third cranial nerve in the interpeduncular cistern. Resolution of the enhancement correlated with resolution of the symptoms. This contrasts with Tolosa-Hunt syndrome where the contrast-enhanced lesion is located at the level of the cavernous sinus. Conclusions: Gd-DPTA enhanced MRI of the brain may act as a useful adjunct in the diagnosis of ophthalmoplegic migraine and may represent a method of differentiating ophthalmoplegic migraine from Tolosa-Hunt syndrome when clinical history is unhelpful.

3. Migraine Chapter, Ophthalmoplegic ,  B.Todd Troost
Discusses guidelines for clinical diagnosis of ophthalmoplegic migraine.Category Health Conditions and Diseases Migraine Ophthalmoplegic......It is clear now that most of the cases of acute third nerve palsy and headache formerlyreferred to as ophthalmoplegic migraine show MRI enhancement of the
http://imigraine.net/migraine/ophthalmoplegic.html
I discussed the nosologic position of this entity in a course at the American Academy of Neurology Meetings in Philadelphia on May 4, 2001. It is clear now that most of the cases of acute third nerve palsy and headache formerly referred to as "ophthalmoplegic migraine" show MRI enhancement of the nerve. This is documented in papers by Wong and Wong in 1197 in Pediatric Neurology and by Mark et al. in the American Journal of Neuroradiology in November 1998. It appears now that this entity is most like Bell's palsy in that it is an isolated "idiopathic" probably post-viral inflammation of a cranial nerve, the III. My earlier discussions of this entity are presented below. I
1. A history of typical migraine headache, ie, a severe throbbing headache usually unilateral, but occasionally bilateral or alternating. It is typically of the crescendo type and may last several hours or days.
2. Ophthalmoplegia including one or more nerves and possibly alternating sides with attacks. Extraocular muscle paralysis may occur with the first attack of headache or, rarely, precede it. However, the paralysis usually appears subsequent to an established migraine pattern.

4. Migraine Chapter, Ophthalmoplegic ,  B.Todd Troost
criteria for the clinical diagnosis of ophthalmoplegic migraine and insufficient knowledge of the pathophysiologic
http://www.imigraine.net/migraine/ophthalmoplegic.html
I discussed the nosologic position of this entity in a course at the American Academy of Neurology Meetings in Philadelphia on May 4, 2001. It is clear now that most of the cases of acute third nerve palsy and headache formerly referred to as "ophthalmoplegic migraine" show MRI enhancement of the nerve. This is documented in papers by Wong and Wong in 1197 in Pediatric Neurology and by Mark et al. in the American Journal of Neuroradiology in November 1998. It appears now that this entity is most like Bell's palsy in that it is an isolated "idiopathic" probably post-viral inflammation of a cranial nerve, the III. My earlier discussions of this entity are presented below. I
1. A history of typical migraine headache, ie, a severe throbbing headache usually unilateral, but occasionally bilateral or alternating. It is typically of the crescendo type and may last several hours or days.
2. Ophthalmoplegia including one or more nerves and possibly alternating sides with attacks. Extraocular muscle paralysis may occur with the first attack of headache or, rarely, precede it. However, the paralysis usually appears subsequent to an established migraine pattern.

5. Migraine Chapter,References,  B.Todd Troost
Alpers BJ, Yaskin HE Pathogenesis of ophthalmoplegic migraine. Walsh JP, O'DohertyDS A possible explanation of the mechanism of ophthalmoplegic migraine.
http://imigraine.net/migraine/refs.html
1. Dalessio DJ: Diagnosing the severe headache. Neurology 1994;(Suppl. 3) 44:6-12.
2. Lipton RB, Stewart WF: Migraine in the United States: epidemiology and health care utilization. Neurology 1993;(Suppl. 3) 43:6-10.
3. Stewart WF, Lipton RB, Celentano DD, et.al. Prevalence of migraine headache in the United States. JAMA 1992;267:64-69.
4. Sacks OW: Migraine, the Evolution of a Common Disorder, Los Angeles, Univ. California Press; 1970:
5. Gowers WR: Subjective visual sensations. Trans Ophthalmol Soc UK 1895;15:1
6. Troost BT, Newton TH: Occipital lobe arteriovenous malformations: Clinical and radiologic features in 26 cases with comments on the differentiation from migraine. Arch Ophthalmol 1975;93:250-256.
7. Headache Classification Committee of the International Headache Society: Classification and diagnostic criteria for headache disorders, cranial neuralgia, and facial pain. Cephalalgia 1988;(Suppl. 7) 8:1-96.
8. Blau JN: Migraine prodromes separated from the aura: complete migraine. Br Med J 1980;281:658-660.

6. Ophthalmoplegic Migraine
Health ophthalmoplegic migraine. A short FAQ on ophthalmoplegic migraine. Migraine Chapter ophthalmoplegic migraine
http://www.northmemorial.com/HealthEncyclopedia/encyclopediaHTML/3138.asp
ophthalmoplegic migraine
Alternative Names

ocular migraine
Definition
Ophthalmoplegic migraine is a form of severe headache that is felt around the eye.
What is going on in the body?
Ophthalmoplegic migraines cause severe headaches with visual phenomena. Rarely do these types of migraines cause permanent damage to vision. Ophthalmoplegic migraine occurs more often as people advance in age. The actual mechanism that causes this type of migraine is not well understood. It has been suspected to involve a combination of conditions surrounding blood vessels that cause inflammation and allergic reactions
What are the signs and symptoms of the infection?
A person with ophthalmoplegic migraine experiences specific eye-related symptoms. These symptoms may differ from person to person but generally include:
  • droopy eyelid, known as ptosis double vision paralysis of the eye other types of vision changes migrainelike pain
What are the causes and risks of the infection?
The true cause of migraine pain is unknown, but there are many theories. The most accepted theory is that migraine is caused by dilated blood vessels in the brain. New research shows that the protective tissue that covers the brain, called the meninges, may become inflamed and cause pain.
What can be done to prevent the infection?

7. Ophthalmoplegic Migraine -- ECureMe.com
ophthalmoplegic migraine, more about ophthalmoplegic migraine, Thisis a more about ophthalmoplegic migraine, .. About Us Home
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Ophthalmoplegic Migraine
more about Ophthalmoplegic Migraine

  • This is a rare variety of Migraine Headache often involving symptoms associated with the paresis of the third, fourth and sixth cranial nerves. In a majority of the cases, this condition occurs in childhood, with cases ranging from infants to adolescents. The third cranial nerve is the one affected most.
    A unilateral (may be alternating or bilateral in some) headache may last for hours or days, and the child may have dilation of the pupils (mydriasis), coupled with the inability to move the eye upward, downward, or medially, as well as a drooping (ptosis) of the upper eyelid.

8. DIRECTORY.TERADEX.COM - Health/Fitness/Diseases/Neurological Disorders/Headaches
MR Imaging in ophthalmoplegic migraine of Children Brief argument that magnetic resonance imaging (MRI) of the brain
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9. February 6, 2003
3. ophthalmoplegic migraine pain(N) around the eye. Headaches - general;Tension headaches; Cluster Headaches; ophthalmoplegic migraine;
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Migraine Headaches
more about Migraine Headaches

Migraines are recurring Headaches that are sometimes accompanied by Nausea Vomiting , sensitivity to light, sound, throbbing pain(N) , and blurred vision.
The two of the most common types are Migraine With Aura (Classic Migraine) and Migraine Without Aura (Common Migraine). The Migraine With Aura yields significant visual changes (bright curved or saw-tooth lines of light or flashing lights with partial vision loss and then returning to normal), sensation loss, or even weakness. The Common Migraine does not have these symptoms.

10. Ophthalmoplegic Migraine
ocular migraine. Definition. ophthalmoplegic migraine is a rare form of migraine headache that is felt around the eye.
http://healthcenters.healthanswers.com/library/medenc/enc/3138.asp
ophthalmoplegic migraine Alternative Names
ocular migraine
Definition
Ophthalmoplegic migraine is a rare form of migraine headache that is felt around the eye. It is often connected with weakness of the muscles around the eye.
What is going on in the body?
An ophthalmoplegic migraine causes severe headache . It also may affect the person's vision. The process that causes this type of migraine is not well understood. One possible cause is inflammation of the blood vessels around the eye. Allergic reactions are another possible cause.
What are the signs and symptoms of the condition?
A person who has ophthalmoplegic migraine has specific symptoms involving the eyes. These symptoms may differ from person to person but most likely include the following: What are the causes and risks of the condition?
A migraine occurs when cells in the brain become overly sensitive to stimulation. This type of migraine may start with an allergic reaction. Or it may begin with inflammation of the blood vessels around the eye. Factors that may trigger a migraine are as follows:
  • alcohol certain foods, including chocolate and some cheeses

11. Retinal And Ophthalmoplegic Migraine
Repeated attacks of......1.3 ophthalmoplegic migraine. . 1.4 RETINAL MIGRAINE. RETURN. 1.3ophthalmoplegic migraine.
http://www.dent.ucla.edu/sod/depts/oralfacial/courses/merrill/ret.html
1.3 OPHTHALMOPLEGIC MIGRAINE 1.4 RETINAL MIGRAINE RETURN 1.3 OPHTHALMOPLEGIC MIGRAINE Description: Repeated attacks of headache associated with paresis of one or more ocular cranial nerves in the absence of demonstrable intracranial lesion. Other cranial nerves may be involved and the following conditions should be considered:
  • Diabetic cranial neuropathy Intracranial aneurysm/tumor Tolosa-Hunt syndrome (painful ophthalmoplegia) Acute glaucoma Ocular pseudotumor CNS infiltrative or infectious disease
NOTE: The fact that this syndrome may involve the oculomotor nerves and the ophthalmic division of the 5th nerve suggests that the anatomic localization of the lesion may be close to the cavernous sinus. Angiographic evidence of constriction of the internal carotic artery in the region of the cavernous sinus has been demonstrated in a few patients during attacks of this headache. Diagnostic Criteria:
  • At least 2 attacks fulfilling B. Headache overlapping with paresis of one or more of cranial nerves III, IV, and VI. Parasellar lesion ruled out by appropriate investigations.
  • 12. Case Of Ophthalmoplegic Migraine Resulting In Ptosis Reported• Your Neurology C
    Physicians from the University of Kentucky, in Lexington, believe they have observed the first case of ophthalmoplegic migraine to occur after childhood and result in
    http://www.neurologychannel.com/NeurologyWorld/case.shtml
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    Botulinum Toxin Therapy Epidural Injection Trigger Point Injection Vagus Nerve Stimulation RESOURCES Clinical Trials Links Videos ABOUT US Healthcommunities.com Pressroom Testimonial Case of Ophthalmoplegic Migraine Resulting in Ptosis Reported WESTPORT, Dec 21 (Reuters Health) - Physicians from the University of Kentucky, in Lexington, believe they have observed the first case of ophthalmoplegic migraine to occur after childhood and result in "permanent neurological deficits." The case involved a 19-year-old woman who presented with acute right ptosis with diplopia. The symptoms began following a 3-day right-sided headache that the patient described as the worst headache of her life. Although she had no history of migraine, persistent nausea and photophobia accompanied the headache. Visual acuity and the results of neurologic examination, magnetic resonance imaging and laboratory findings were normal, and the patient was discharged. However, she presented 4 days later with a recurrence of the headache and worsening ptosis.

    13. National Headache Foundation: Ophthalmoplegic Migraine
    Brief description of the condition.Category Health Conditions and Diseases Migraine Ophthalmoplegic......ophthalmoplegic migraine. ophthalmoplegic migraine is a rare conditionconsidered to be an unusual form of migraine. The pain usually
    http://www.headaches.org/consumer/topicsheets/ophthalmoplegic.html

    Consumer Topics
    Medications Spanish Topics
    OPHTHALMOPLEGIC MIGRAINE
    Ophthalmoplegic migraine is a rare condition considered to be an unusual form of migraine. The pain usually surrounds the eyeball and lasts from a few days to a few months, associated with weakness of the muscles surrounding the eye. It is important to confirm the diagnosis of ophthalmoplegic migraine as similar symptoms can be caused by pressure on the nerves behind the eye. top of page

    14. Headaches Types | Migraine
    ophthalmoplegic migraine Also a rare and severe migraine, the ophthalmoplegic migraine’spain usually surrounds the eyeball and lasts from a few days to a
    http://www.headaches.org/consumer/educationalmodules/completeguide/migraine2.htm
    Headache MIGRAINE
    Symptoms
    There are several types of migraine, all share basic features, and each person will suffer this headache in a unique way. Generally, however, migraine often begins as a dull ache and then develops into a constant, throbbing and pulsating pain that you may feel at the temples, as well as the front or back of one side of the head. The pain is usually accompanied by nausea and vomiting, and sensitivity to light and noise. The two most prevalent types of migraine are migraine with aura (formerly referred to as classic migraine) and migraine without aura (formerly referred to as common migraine).
    Migraine without Aura
    As we have said, migraine is a vascular headache, which means the headache is associated with changes in the size of the arteries inside and around the skull. During the pre-headache phase, blood vessels constrict; when vascular dilation occurs, the migraine begins. The blood vessels are thought to become inflamed as well as swollen, and it is believed that migraine pain is caused by this inflammation, as well as by the pressure on the swollen walls of the blood vessels. Most migraine sufferers experience two to four headaches per month; but, some people can get one every few days, and others may only have one or two a year. Most migraine headaches last at least four hours, although very severe ones can last up to a week. Headaches may begin at any time of the day or night; and while a sufferer may wake up with one, a migraine will rarely awaken a person from sleep.

    15. Member Sign In
    Can you differentiate ophthalmoplegic migraine from cerebral aneurysmby clinical history and exam? Focus On
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    17. Ophthalmoplegic Migraine
    ophthalmoplegic migraine Alternative Names ocular migraine Definition Ophthalmoplegicmigraine is a rare form of migraine headache that is felt around the eye.
    http://atoz.iqhealth.com/HealthAnswers/encyclopedia/HTMLfiles/3138.html
    ophthalmoplegic migraine Alternative Names
    ocular migraine
    Definition
    Ophthalmoplegic migraine is a rare form of migraine headache that is felt around the eye. It is often connected with weakness of the muscles around the eye.
    What is going on in the body?
    An ophthalmoplegic migraine causes severe headache . It also may affect the person's vision. The process that causes this type of migraine is not well understood. One possible cause is inflammation of the blood vessels around the eye. Allergic reactions are another possible cause.
    What are the signs and symptoms of the condition?
    A person who has ophthalmoplegic migraine has specific symptoms involving the eyes. These symptoms may differ from person to person but most likely include the following: What are the causes and risks of the condition?
    A migraine occurs when cells in the brain become overly sensitive to stimulation. This type of migraine may start with an allergic reaction. Or it may begin with inflammation of the blood vessels around the eye. Factors that may trigger a migraine are as follows:
    • alcohol certain foods, including chocolate and some cheeses

    18. AHS: October 1999
    Strambi, MD. ophthalmoplegic migraine With Unusual Features HS O’Halloran,FRCSI; WB Lee, MD; RS Baker, MD; PA Pearson, MD. Estrogen
    http://www.ahsnet.org/journal/toc-1999-10.php
    Headache
    October 1999 Headache Subscribe 41st Annual Scientific Meeting Abstracts 40th Annual Scientific Meeting Abstracts Recent Issues ... Archived Issues HEADACHE
    THE JOURNAL OF HEAD AND FACE PAIN
    VOLUME 39, NUMBER 9 OCTOBER, 1999 CONTENTS OF OCTOBER ISSUE ORIGINAL ARTICLES
    Cardiovascular Responses to Pain and Stress in Migraine
    Hilary J. Hassinger, MA; Elizabeth M. Semenchuk, PhD; William H. O’Brien, PhD Recurrent Headache in Adolescents: Nonreferred Versus Clinic Population
    Mark Scott Smith, MD; Susanne Pelley Martin-Herz, MS; William M. Womack, MD; Robert J. McMahon, PhD Longitudinal Prospective Study of Headache During Pregnancy and Postpartum
    Dawn A. Marcus, MD; Lisa Scharff, PhD; Dennis Turk, PhD Safety of Divalproex Sodium in Migraine Prophylaxis: An Open-Label, Long-term Study
    Stephen D. Silberstein, MD; Stephen D. Collins, MD, PhD; for the Long-term Safety of Depakote in Headache Prophylaxis Study Group Amino Acids in the Saliva of Patients With Migraine
    Management of Chronic Daily Headache Utilizing a Uniform Treatment Pathway

    John F. Rothrock, MD Objective Behavior Associated With an "Ordinary" Mild Headache: A Surprising Failure of Pain Onset to Signal Self-protective or Self-regulatory Behavior Christine A. Hovanitz, PhD; David J. Reynolds, MS; Max P. Cote, BA; Amy Christianson, BA; Linda A. Stokes-Crowe, PhD; Shari Altum, MS; Cheryl Anne Chase, BA

    19. 1.3 Ophthalmoplegic Migraine
    First Previous Next Last Index Home Text. Slide 22 of 43.
    http://www.wfubmc.edu/neurology/lectures/slctalks/slcmigraine/sld022.htm

    20. Ophthalmoplegic Migraine Is NOT
    First Previous Next Last Index Home Text. Slide 23 of 43.
    http://www.wfubmc.edu/neurology/lectures/slctalks/slcmigraine/sld023.htm

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