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The Journal of Headache and Pain

Official Journal of the "European Headache Federation" and of "Lifting The Burden - The Global Campaign against Headache"

The Journal of Headache and Pain Cover Image
Open Access

Is migraine with cranial nerve palsy an ophthalmoplegic migraine?

  • Pierric Giraud1Email author,
  • Dominique Valade2,
  • Michel Lanteri-Minet3,
  • Anne Donnet4,
  • Gilles Geraud5,
  • Evelyne Guégan-Massardier6 and
  • and the Observatoire des Migraines et Céphalées of the French Headache Society
The Journal of Headache and Pain20078:371

Received: 27 November 2006

Accepted: 14 February 2007

Published: 11 May 2007


Ophthalmoplegic migraine (OM) is a rare form of primary headache. Because of its rarity, only a few cases, mostly symptomatic, are reported. We analyse nine cases among 52 973 adults who suffer from headaches with an oculomotor palsy firstly considered as OM. The study was retrospective and multicentric in a database set up in France. The aim of our investigation was to describe the clinical and radiological aspects of these cases and to discuss the diagnosis of OM. We demonstrate that the characteristics of the headaches were identical to usual migraine without oculomotor nerve palsy for each case. The study emphasises the difficulty of the OM diagnosis even with the new IHS criteria because of the rarity of having all characateristics. A wide heterogeneity was noted in cranial imagery and blood tests. We suggest adding the code of probable OM in the IHS classification to increase the knowledge and detection of this type of headache. A biological blood test and an MRI are systematically required to help clinicians in their diagnosis and to exclude alternative aetiology of headache with palsy.


Ophtalmoplegic migraineCranial nerve palsyMigraine and ocular palsy


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