Opthalmoplegic Migrane with Recurrent Sixth Nerve Palsy: A Rare Presentation of Headache in a Young Lady

Authors

  • Monzurul H Chowdhury Postgraduate Trainee, Department of Medicine, Dhaka Medical College Hospital, Dhaka
  • Zannatun Nur Postgraduate Trainee, Department of Medicine, Dhaka Medical College Hospital, Dhaka
  • Hosne Ara Begum Postgraduate Trainee, Department of Medicine, Dhaka Medical College Hospital, Dhaka
  • Md Shahriar Mahbub Postgraduate Trainee, Department of Medicine, Dhaka Medical College Hospital, Dhaka
  • HAM Nazmul Ahasan Professor and Head, Department of Medicine, Dhaka Medical College, Dhaka

DOI:

https://doi.org/10.3329/jom.v10i2.2833

Keywords:

Migraine, Opthalmoplegic migraine, Abducens nerve palsy

Abstract

Migraine is a common presentation of headache but migraine with opthalmoplegia with third nerve palsy is rare and with fourth or sixth nerve palsy is very rare. Although it represents a benign course, duration and severity are variable among the patients. We demonstrated a young lady presenting with right hemicranial headache for 12 days with several episodes of vomiting. She also complained of double vision for 7 days. The headache started from the inner canthus of right eye and gradually spread throughout the right half of head over 2 hours and was throbbing in nature. She also complained of double vision from 5th day after onset of headache. Interestingly, she informed similar types of attack for two episodes in last 1 year which persisted for around 22-25 days each time. On examination, she appeared ill looking with convergent squint on right lateral gaze. Cranial nerves examinations showed all the cranial nerves were intact except right sixth cranial nerve palsy. Laboratory investigations and neuroimaging were normal. Our case fulfilled the International Classification of Headache Disorders (ICHD II) criteria for opthalmoplegic migraine with recurrent six nerve palsy which responded dramatically with prednisolone therapy 1mg/kg/day which also prevented recurrence within 6 months.

Keyword: Migraine, Opthalmoplegic migraine, Abducens nerve palsy.  

doi: 10.3329/jom.v10i2.2833  

J MEDICINE 2009; 10 : 139-141

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How to Cite

Chowdhury, M. H., Nur, Z., Begum, H. A., Mahbub, M. S., & Ahasan, H. N. (2009). Opthalmoplegic Migrane with Recurrent Sixth Nerve Palsy: A Rare Presentation of Headache in a Young Lady. Journal of Medicine, 10(2), 139–141. https://doi.org/10.3329/jom.v10i2.2833

Issue

Section

Case Reports