Department of Basic Medical Sciences, Neurosciences and Sense Organs Department, University of Bari "Aldo Moro", Bari, Italy.
Pain Res Manag. 2019 Sep 25;2019:5392945. doi: 10.1155/2019/5392945. eCollection 2019.
Recurrent painful ophthalmoplegic neuropathy (RPON), previously known as ophthalmoplegic migraine (OM), is an uncommon disorder with repeated episodes of ocular cranial nerve neuropathy associated with ipsilateral headache. The age of presentation is most often during childhood or adolescence. MRI has a central role in the assessment of the RPON, especially to distinguish orbital, parasellar, or posterior fossa lesions that mimic symptoms of RPON. Actually, oculomotor nerve tumors may be masquerade as RPON so that MRI follow-ups are required to detect the possibility of tumor etiology.
We report a 16-year-old boy with a 7-year follow-up and multiple brain MRI data, previously diagnosed as OM. The last brain MRI, performed during an acute phase of oculomotor paresis with ipsilateral headache, showed a nodular lesion described as schwannoma of III cranial nerve. Then, we reviewed the literature on OM and RPON in pediatric age with a focus on brain MRI findings.
This review highlights the important role of serial brain MRIs in the long-term follow-up of RPON, especially in the cases with childhood onset, in order to not delay the diagnosis of a possible oculomotor nerve schwannoma.
复发性疼痛性眼肌神经病（RPON），以前称为眼肌性偏头痛（OM），是一种不常见的疾病，会反复发作眼颅神经神经病，并伴有同侧头痛。发病年龄通常在儿童期或青春期。MRI 在评估 RPON 中具有核心作用，特别是用于区分模仿 RPON 症状的眶内、鞍旁或后颅窝病变。实际上，动眼神经肿瘤可能伪装为 RPON，因此需要进行 MRI 随访以检测肿瘤病因的可能性。
我们报告了一例 16 岁男孩，他在 7 年的随访中有多次脑部 MRI 数据，之前被诊断为 OM。最后一次脑部 MRI 在动眼神经麻痹的急性期中进行，同侧头痛，显示一个结节性病变，描述为 III 颅神经神经鞘瘤。然后，我们回顾了儿科年龄 OM 和 RPON 的文献，重点是脑 MRI 发现。
这篇综述强调了连续脑部 MRI 在 RPON 长期随访中的重要作用，特别是在儿童期发病的情况下，以避免延误可能的动眼神经神经鞘瘤的诊断。
