INTERESTING CASE OF MIGRAINE

Abstract

Abstract : 14 yr old female , a known migraine patient ,          admitted for severe headache with aura and ptosis on left eye with double vision on looking upwards, on examination, her visual acuity was diminished in left eye, subsequently on 9th day of admission, patient developed restricted movement on elevation in left eye. On33rd day elevation,depression and adduction was restricted with dilated pupil in left eye. On day 44th , her eye movements improved on treatment with               steroids. As defined by International Headache Society ,      patient with recurrent headache of migrainous characteristics with transient paralysis of ocular nerve (3rd nerve in our             patient ), with dilated pupil and normal CSF analysis,on follow up showing resolvement of symptoms,CT showing bilateral occipital infarct, MRI showing FLAIR images of hyperintense lesion in both occipital areas, MR angiogram showing bilateral posterior cerebral artery vasospasm, with persistent                  diminished visual acuity in left eye. Our patient fits into               diagnosis of migraine with aura, complicated by migrainous infarction and ophthalmoplegic migraine. In literature this complication is stated as rare entity, we present this rare case of complicated migraine with both migrainous infarction and ophthalmoplegic migraine

Keyword :Migraine,Migraine with aura, migrainous infarction, ophthalmoplegic migraine