Bui Linda T, Mainali Gayatra, Naik Sunil, Cockroft Kevin, Thamburaj Krishnamoorthy
Radiology, Penn State College of Medicine, Hershey, USA.
Pediatric Neurology, Penn State Health Milton S. Hershey Medical Center, Hershey, USA.
Cureus. 2022 Mar 7;14(3):e22919. doi: 10.7759/cureus.22919. eCollection 2022 Mar.
Ophthalmoplegic migraine is considered to occur more commonly in children than in adults. It commonly affects the oculomotor nerve among the cranial nerves. Demyelination of the nerve is proposed as the main mechanism for the etiology of ophthalmoplegic migraine, though it is not fully understood. Neurovascular compression as a cause of ophthalmoplegic migraine has not been well demonstrated in children. In this report, we present a case of a 13-year-old male with recurrent episodes of left ophthalmoplegic migraine. Oculomotor nerve enhancement with swelling was evident on MRI at the exit zone. Magnetic resonance angiography (MRA) revealed a sharp loop of the left posterior cerebral artery compressing the nerve. The case highlighted the unusual etiology of neurovascular compression resulting in ophthalmoplegic migraine in a pediatric patient. A supplemental case of ophthalmoplegic migraine in a seven-year-old male is also shown to highlight the role of neurovascular compression and the importance of using MR angiography to evaluate cases presenting clinically with ophthalmoplegic migraine.
眼肌麻痹性偏头痛被认为在儿童中比在成人中更常见。它通常影响颅神经中的动眼神经。尽管尚未完全了解，但神经脱髓鞘被认为是眼肌麻痹性偏头痛病因的主要机制。作为眼肌麻痹性偏头痛病因的神经血管压迫在儿童中尚未得到充分证实。在本报告中，我们介绍了一名13岁男性反复出现左眼球麻痹性偏头痛发作的病例。MRI显示在神经出口区动眼神经强化并肿胀。磁共振血管造影（MRA）显示左大脑后动脉有一个尖锐的袢压迫神经。该病例突出了导致小儿患者眼肌麻痹性偏头痛的神经血管压迫这一不寻常病因。还展示了一名7岁男性眼肌麻痹性偏头痛的补充病例，以突出神经血管压迫的作用以及使用磁共振血管造影评估临床上表现为眼肌麻痹性偏头痛病例的重要性。
