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ophthalmoplegic migraine

Alternative Names
ocular migraine

Definition
Ophthalmoplegic migraine is a form of severe headache that is felt around the eye.

What is going on in the body?
Ophthalmoplegic migraines cause severe headaches with visual phenomena. Rarely do these types of migraines cause permanent damage to vision. Ophthalmoplegic migraine occurs more often as people advance in age. The actual mechanism that causes this type of migraine is not well understood. It has been suspected to involve a combination of conditions surrounding blood vessels that cause inflammation and allergic reactions.

What are the signs and symptoms of the infection?
A person with ophthalmoplegic migraine experiences specific eye-related symptoms. These symptoms may differ from person to person but generally include:
  • droopy eyelid, known as ptosis
  • double vision
  • paralysis of the eye
  • other types of vision changes
  • migraine-like pain
What are the causes and risks of the infection?
The true cause of migraine pain is unknown, but there are many theories. The most accepted theory is that migraine is caused by dilated blood vessels in the brain. New research shows that the protective tissue that covers the brain, called the meninges, may become inflamed and cause pain.

What can be done to prevent the infection?
Many people find that certain things trigger migraine pain, including ophthalmoplegic migraine pain. Allergies, the weather, certain foods, smoking, or alcohol are among the common migraine triggers. Someone who experiences migraine will want to work with their doctor to understand his or her personal triggers. The key is, then, to avoid triggers in daily life. Some medications may also prevent migraine pain. A person who has more than 2 headaches a month may be a candidate for preventive medications.

How is the infection diagnosed?
Ophthalmoplegic migraines are usually diagnosed after at least 3 episodes of migraine that involve only symptoms of the eye. The repeated attacks usually include blind spots on 1 side or blindness lasting less than an hour. These types of eye symptoms can be frightening, especially to an older person. Eye diseases or disorders of the blood vessels that lead to the eye need to be ruled out before a diagnosis of ophthalmoplegic migraines can be made.

What are the long-term effects of the infection?
Some people may have permanent vision problems after experiencing ophthalmoplegic migraines.

What are the risks to others?
Ophthalmoplegic migraines are not contagious, and pose no risk to others.

What are the treatments for the infection?
The same medications used to treat migraine are commonly used to treat ophthalmoplegic migraine. There is no exclusive medication for this condition. There are two major types of medications available for treating migraines:
  • abortive medications, which are used to treat migraine symptoms once the symptoms have begun. Abortive medications include ergotamine preparations, DHE, 5-HT agonists, and anti-inflammatory medications.
  • preventive medications. These are designed to prevent migraines in people who have frequent or very severe symptoms that interfere with work or social activities. Preventive medications include beta-blockers, antidepressants, NSAIDs, and channel blockers.
What are the side effects of the treatments?
Depending on the type of migraine medication, side effects can range from dry mouth, nausea, and vomiting, to liver damage, kidney damage, and chest pain.

What happens after treatment for the infection?
After treatment, the initial symptoms of ophthalmoplegic migraine may subside. People sometimes report feeling tired after coping with migraine symptoms.

How is the infection monitored?
Ophthalmoplegic migraines are monitored with ongoing vision tests to rule out any other type of eye disease.

Author: Terry Mason, MPH
Reviewer: HealthAnswers Australia Medical Review Panel
Editor: Dr David Taylor, Chief Medical Officer HealthAnswers Australia
Last Updated: 1/10/2001
Contributors
Potential conflict of interest information for reviewers available on request


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