OPHTHALMOPLEGIC migraine was first defined by Charcot1 in 1890 as a "condition associated with migraine in which there is a palsy of an ocular nerve, usually the third, temporary at first and later becoming permanent."
This clinical syndrome is characterized by paroxysmal, recurrent, transient partial or total ophthalmoplegia associated with severe hemicrania and with or without scintillating scotoma, homonymous hemianopsia, depression, general malaise, nausea and vasomotor disturbances. It frequently progresses to total and permanent unilateral oculomotor paralysis.
Numerous individual variations and atypical paralyses were adequately reviewed by Alpers and Yaskin,2 but the patient with typical ophthalmoplegic migraine presents the following clinical picture:
There is a history of typical migraine attacks, without ocular muscle paralysis, of many years' duration, prior to the first attack of ophthalmoplegia.
The individual attack may begin, as in any other form of migraine, with scintillating scotoma and homonymous hemianopsia, followed by severe
HARRINGTON DO, FLOCKS M. OPHTHALMOPLEGIC MIGRAINEPathogenesis; Report of Pathological Findings in a Case of Recurrent Oculomotor Paralysis. AMA Arch Ophthalmol. 1953;49(6):643-655. doi:10.1001/archopht.1953.00920020656005