What is an Ophthalmoplegic Migraine?

Ophthalmoplegic migraine is a rare migraine variant that includes temporary partial paralysis or one or more of the nerves that controls eye movement. As a result, the patient's eyes will not be as mobile as they normally are and the patient can experience a variety of visual symptoms. These symptoms can linger for several days after the migraine itself in some cases. People who develop visual disturbances or notice signs of paralysis around the eyes can seek evaluation from an ophthalmologist who will conduct an examination and may recommend a referral to a neurologist.

In an ophthalmoplegic migraine, the patient experiences a classic migraine headache, which is an intense headache that usually builds over several hours and can persist for an extended period of time. In addition, visual disturbances like blurred vision, double vision, and blindness can be experienced. One or both eyes may be unable to move and the patient can develop drooping eyelids as well. When the headache resolves, visual problems may persist until the nerves around the eye have recovered.

The causes of migraine are not well understood, but are believed to be linked to problems with bloodflow in the brain. In the case of ophthalmoplegic migraines, the changes in blood flow also involve the nerves around the eyes. This condition often onsets in childhood, although it can be documented in adults as well. If someone experiences symptoms like double vision and drooping eyelids while a migraine is occurring, there is a strong probability that it is an ophthalmoplegic migraine.

Evaluation from a neurologist will be needed to diagnose migraines and rule out other neurological causes for headaches and visual disturbances like tumors and degenerative diseases. There are some medications available to prevent migraines and treat them while they are occurring that can be prescribed to a patient with a history of ophthalmoplegic migraine. In addition, some patients experience success with lifestyle modifications such as dietary changes and avoidance of migraine triggers like strong odors and bright light. Every patient is slightly different and it may be necessary to explore several treatment options to find one that works.

It is possible for a patient who experiences ophthalmoplegic migraine to develop headaches without eye problems, or to have visual disturbances without headaches. Patients in treatment for migraine may find it helpful to keep a journal of symptoms and their duration. This information can be useful for the development or assessment of a treatment plan.