A RARE CAUSE OF SIXTH NERVE PALSY: OPHTALMOPLEGIC MIGRAINE

Year 2014, Volume: 6 Issue: 2, 1 - 3, 01.08.2014

Miraç Ayşen Çakmak Şevki Şahin Nilgün Çınar Cevher Önay Sibel Karşıdağ

Abstract

Ophthalmoplegic migraine OM is typically migraine- like pain accompanied with III., IV. and/or VI. cranial nerve involvement. The most recent opinion about pathophysiology is inflammatory demyelinating neuropathy of affected cranial nerve. Herein, we present 24-year-old female who developed restriction of lateral gaze of the right eye 3 days after hemicranial throbbing headache onset. Her previous medical history included a similar scenario which resolved without treatment one year ago. Routine biochemical, hematological, cerebrospinal fluid analyses and imaging studies were in normal limits. Because of the history of a similar attack one year a go, she was diagnosed with OM. Parenterally corticosteroid treatment was started. The patients headache and restricted eye movements showed significant improvement. Patients with ophtalmoplegy should always be questioned for headache to prevent unnecessary and expensive procedures.

Keywords

VI.th cranial nerve palsy, ophthalmoplegia, migraine

NADİR BİR ALTINCI SİNİR FELCİ NEDENİ: OFTALMOPLEJİK MİGREN

Abstract

Oftalmoplejik migren OM tipik olarak migren- benzeri bir ağrıya eşlik eden III., IV. ve/veya VI. kraniyal sinir tutulumudur. Patofizyolojisi konusunda en güncel görüş, etkilenen kraniyal sinirde inflamatuar demiyelinizan bir nöropatinin var olduğu yönündedir. Burada, 24 yaşında bir kadında yeni başlayan sağ hemikraniyal zonklayıcı baş ağrısını takip eden 3 gün içinde, sağ gözde gelişen dışa bakış kısıtlığı tablosu sunulmuştur. Olguda bir yıl önce benzer bir tablonun geliştiği ve tedavisiz düzeldiği öğrenildi. Rutin biyokimyasal, hematolojik, beyin omurilik sıvısı incelemesi ve görüntüleme yöntemleri normal sınırlarda idi. Olguya altta yatan bir sebebin bulunmaması ve bir yıl önceki öyküsü nedeniyle OM tanısı konarak kortikosteroid tedavi başlandı. Hastanın ağrısında ve kısıtlı olan göz hareketlerinde belirgin düzelme izlendi. Oftalmopleji ile gelen hastalarda baş ağrısı öyküsü mutlaka sorgulanmalıdır. OM tanısının düşünülmesi hastaların gereksiz ve pahalı tetkiklere yönlendirilmemesi açısından önemlidir.

Keywords

VI. kranyal sinir felci, oftalmopleji, migren

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