Ophthalmoplegic migraine syndrome

General: Symptoms produced by ipsilateral herniation of hippocampal gyrus of tempora 545d33f l lobe through incisura tentorii; dependent upon unilateral cerebral edema due to vascular or vasomotor phenomena, intracranial aneurysm, or tumor; incidence may be greater in women with the initial attack in the first decade of life; pathogenesis is unclear, but it is likely secondary to ischemia of the ocular motor nerve.

Ocular: Severe unilateral supraorbital pain; ptosis; transitory partial or complete homolateral oculomotor paralysis; fourth or sixth nerve occasionally involved; retinal hemorrhages; papilledema (may be bilateral); moderate to severe headache with partial to complete cranial nerve III paresis including the pupil; more than one ocular nerve may be affected.

Clinical: Migraine headache, not present in all instances; dizziness; diminution in sense of smell; hypalgesia contralateral side of face; nausea/vomiting may be present; recurrent sinus arrest.

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