• Lucia Margari, Anna R Legrottaglie, Francesco Craig, Maria G Petruzzelli, Ugo Procoli, and Franca Dicuonzo.
• Child Neuropsychiatry Unit, Department of Neuroscience and Sense Organs, University of "Aldo Moro" Bari, Italy. l.margari@neurol.uniba.it
• Cephalalgia. 2012 Dec 1;32(16):1208-15.

BackgroundOphthalmoplegic migraine (OM) is a rare condition characterized by the association of headaches and an oculomotor nerve palsy. The third cranial nerve is commonly involved in recurrent attacks, whereas involvement of the sixth and fourth nerves is uncommon. It is still debated whether an uncontrolled migraine or an oculomotor neuropathy may be the primary cause of ophthalmoplegic migraine.CasesWe report two patients affected by OM with normal magnetic resonance imaging findings and a history of uncontrolled migraine before an attack of OM.ConclusionThe cases reported allow us to hypothesize that OM may be considered a form of migraine rather than a cranial neuralgia. It is possible that different factors such as inflammatory or structural factors, may represent a vulnerability of the nerve during a severe migraine attack causing ophthalmoplegia.

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