A Case of Ophthalmoplegic Migraine ; Reversible Ischemia Demontrated by Brain SPECT

J Korean Neurol Assoc > Volume 14(4); 1996 > Article

Journal of the Korean Neurological Association 1996;14(4): 989-994.

Brain SPECT상 우측 시상에 가역적 허혈을 보인 안근마비성 편두통 1례

하경식, 신동진

중앙 길병원 신경과

A Case of Ophthalmoplegic Migraine ; Reversible Ischemia Demontrated by Brain SPECT

Kyung-Sik Ha, M. D., Dong-Jin Shin, M. D.

Department of Neurology, Chung-Ang Gil General Hospital

Abstract

Ophthalmoplegic migraine is a syndrome characterized by the typical history of migrainous headache followed by ophthalmoplegia in the absence of demonstrable intracranial lesion. Until now, investigations of regional cerebral blood flow (CBF) in patient,; with migraine have been performed during prodromal and/or headache phases by brain SPECT with Tc-99m HMPAO. However, no such paper has described patients with ophthalmoplegic migraine. We present a 14-year-old girl with 4 episodes of paroxysmal migrainous headache on the right fronto-orbital area without aura followed by ptosis and diplopia, which were always gradually resolved without aberrant regeneration over 2 or 3 weeks period. Neurologic examination showed the right internal and external ophthalmoplegia. Diagnostic studies (including laboratory testis, Tensilon test, brain MRI, and cerebral angiography) were normal. Serial brain SPECT studies with Tc-99m HMPAO showed the presence of reversible ischemia in the branches of the posterior cerebral artery.