FP587

Ophthalmoplegic Migraine: A rare etiology of 3rd cranial nerve palsy

PURPOSE: To report a rare case of patient with episode of ipsilateral headache followed by oculomotor nerve palsy.
CASE REPORT: A 36 year old male who is a known case of migraine since childhood, presented with sudden drooping of right upper lid with diplopia preceded by headache since 3 days.Ocular examination revealed pupil sparing 3rd cranial nerve palsy with a normal fundus examination.MRI Brain was normal.Blood investigations showed borderline elevated serum IgG4. According to ICHD 3 criteria, a provisional diagnosis of ophthalmoplegic migraine was made and referred to neurologist .Tapering dose of oral steroids was started,to which patient responded well with complete recovery within 10 days.
CONCLUSION: Ophthalmoplegic migraine is a rare neurological syndrome with incidence of 0.7 per million and a diagnosis of exclusion for which differential diagnosis of painful ophthalmoparesis, such as tumour, infection, and vascular causes have been excluded by appropriate imaging.