Mark A S, Casselman J, Brown D, Sanchez J, Kolsky M, Larsen T C, Lavin P, Ferraraccio B
Washington Hospital Center, Washington, DC 20010, USA.
AJNR Am J Neuroradiol. 1998 Nov-Dec;19(10):1887-91.
Ophthalmoplegic migraine is a rare condition characterized by the association of headaches and an oculomotor nerve palsy. We report six patients with typical clinical features of this disorder in whom enhancement of the cisternal segment of the oculomotor nerve developed during the acute phase, followed by resolution of enhancement over several weeks as the symptoms resolved.
Six patients, ages 3 to 27 years, underwent MR imaging during the acute phase of ophthalmoplegic migraine and at the time of recovery several weeks later. The MR studies, performed on a 1.5-T MR unit, included noncontrast and contrast-enhanced axial and coronal T1-weighted sequences. Sagittal images were obtained in two patients, with and without contrast enhancement.
Enhancement of the cisternal segment of the oculomotor nerve was seen in all patients at initial presentation. Contrast-enhanced studies also showed focal thickening at the exit of the nerve in the interpeduncular cistern in five of six patients. No patient had enhancement of the cavernous sinus or adjacent dura. Enhancement was almost completely resolved on follow-up studies 7 to 9 weeks later.
Our findings confirm an intrinsic transient abnormality in the cisternal segment of the third nerve in patients with a typical clinical presentation of ophthalmoplegic migraine.
眼肌麻痹性偏头痛是一种罕见疾病，其特征为头痛与动眼神经麻痹并存。我们报告6例具有该疾病典型临床特征的患者，这些患者在急性期动眼神经脑池段出现强化，随着症状缓解，强化在数周内消退。
6例年龄在3至27岁的患者在眼肌麻痹性偏头痛急性期及数周后恢复时接受了磁共振成像检查。磁共振检查在1.5T磁共振设备上进行，包括非增强及增强后的轴位和冠状位T1加权序列。2例患者还获得了矢状位图像，包括增强及未增强的图像。
所有患者初次就诊时均可见动眼神经脑池段强化。增强检查还显示6例患者中有5例在脚间池神经出口处有局灶性增粗。无患者海绵窦或邻近硬脑膜强化。7至9周后的随访检查显示强化几乎完全消退。
我们的研究结果证实，具有眼肌麻痹性偏头痛典型临床表现患者的动眼神经脑池段存在内在的短暂异常。
