Internal ophthalmoplegic migraine during pregnancy: a clinical case
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Fecha
2025
Autores
Castillo-Guerrero, Brenda
Londoño-Juliao, Gloria
pianetta, yesenia
Gutiérrez-Rey, Melissa
Zuñiga, Bley Jair
Pestana, Gustavo
Carbonell-Zabaleta, Ana-Karina
Rivera-Porras, Diego
Bermudez, Valmore
VARGAS MANOTAS, JOSE
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MDPI
Ediciones Universidad Simón Bolívar
Facultad de Ciencias de la Salud
Ediciones Universidad Simón Bolívar
Facultad de Ciencias de la Salud
Resumen
Abstract: Background: Ophthalmoplegic migraine (OM) is an uncommon variant of migraine characterised
by headache and cranial nerve palsy, posing significant diagnostic and therapeutic challenges.
Objective: This study aimed to describe an extremely rare OM variant with a partial therapeutic
response. Clinical Case: A 34-year-old pregnant woman in gestational week 19.1 (G6P2A3) with
a history of three consecutive spontaneous abortions presented at the emergency services with
insidious onset and mild-to-moderate-intensity pulsatile bifrontal headache for 15 days, and the
positional changes exacerbated this. At peak intensity, she experienced nausea, vomiting, tinnitus,
and photophobia without phonophobia or osmophobia, prompting multiple visits to the emergency
department. Despite a broad range of treatments, including intravenous fluids, analgesia, pericranial
blocks, and preventive management, there was a non-significative improvement in the symptomatology
described above. However, spontaneous resolution of this clinical picture was observed during
the postpartum period. Results: This case highlights the complexity of ophthalmoplegic migraine,
especially in the context of pregnancy, and raises questions about the underlying pathophysiological
mechanisms. The absence of structural lesions on neuroimaging and postpartum resolution suggests
a potential association with the hormonal and physiological changes associated with pregnancy.
Conclusions: Despite limited scientific evidence, this report contributes to expanding the knowledge
of this rare entity and emphasises the importance of a multidisciplinary approach to its management.
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Castillo-Guerrero, B.; Londoño-Juliao, G.; Pianetta, Y.; Gutiérrez-Rey, M.; Zuñiga, B.J.; Pestana, G.; Carbonell-Zabaleta, A.-K.; Rivera-Porras, D.; Bermúdez, V.; Vargas-Manotas, J. Internal Ophthalmoplegic Migraine During Pregnancy: A Clinical Case. Neurol. Int. 2024, 16, 1779–1787. https://doi.org/10.3390/neurolint16060128
