Overview, Causes, & Risk Factors

Ophthalmoplegic migraine is a rare form of migraine headache that is felt around the eye. It is often connected with weakness of the muscles around the eye.

What is going on in the body?

An ophthalmoplegic migraine causes severe headache. It also may affect the person's vision. The process that causes this type of migraine is not well understood. One possible cause is inflammation of the blood vessels around the eye. Allergic reactions are another possible cause.

What are the causes and risks of the condition?

A migraine occurs when cells in the brain become overly sensitive to stimulation. This type of migraine may start with an allergic reaction. Or it may begin with inflammation of the blood vessels around the eye. Factors that may trigger a migraine are as follows:

alcohol

certain foods, including chocolate and some cheeses

change in hormone levels

fatigue

food additives

foods containing tyramine, such as red wine and organ meats

light or noise

too much or too little sleep

weather changes

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Symptoms & Signs

What are the signs and symptoms of the condition?

A person who has ophthalmoplegic migraine has specific symptoms involving the eyes. These symptoms may differ from person to person but most likely include the following:

double vision

droopy eyelid, known as ptosis

eye paralysis

other types of vision changes

severe headache pain

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Diagnosis & Tests

How is the condition diagnosed?

Diagnosis of ophthalmoplegic migraine begins with a medical history and physical exam. Other eye disorders need to be ruled out before a diagnosis of ophthalmoplegic migraines can be made.

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Prevention & Expectations

What can be done to prevent the condition?

A person can lower the risk for migraine by identifying and avoiding triggers. People who are sensitive to tyramine, for example, should not drink red wine. Medicines used to prevent migraines include the following:

anticonvulsants, such as gabapentin and carbamazepine

beta-blockers, such as atenolol and propanolol

calcium channel blockers, such as diltiazem and verapamil

lithium carbonate

methysergide maleate and methylergonovine maleate

nonsteroidal anti-inflammatory drugs, or NSAIDs, such as ibuprofen and naproxen

other antidepressants, such as trazodone and venlafaxine HCl

selective serotonin reuptake inhibitors, also called SSRIs, including paroxetine HCl and fluoxetine HCl

tricyclic antidepressants, such as amitriptyline and nortriptyline

What are the long-term effects of the condition?

Rarely, a person may have permanent vision problems after ophthalmoplegic migraines.

What are the risks to others?

Ophthalmoplegic migraines are not contagious. They pose no risk to others.

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Treatment & Monitoring

What are the treatments for the condition?

Following are some of the medicines used to relieve the symptoms of migraine:

barbiturate combinations, such as butalbital with caffeine and acetaminophen

ergot alkaloids and derivatives, such as ergotamine

isometheptene agents

narcotic analgesics, such as codeine and butorphanol

pain medicines, such as ibuprofen and acetaminophen

triptans or serotonin, or 5HT-1, receptor agonists, such as sumatriptan succinate

Alternative and complementary therapies for migraine include:

acupuncture, a therapy used to relieve pain by putting thin needles into certain parts of the body

aromatherapy, which uses oils to stimulate pleasant sensations and relieve stress

biofeedback, a process in which a person is taught how to relax when the body starts to show the signs of a headache

chiropractic, which involves manipulation of the spinal bones

anxiety

depression

eating disorders such as anorexia nervosa and bulimia

alcohol and drug abuse problems

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exercise

herbal remedies

hypnosis, which uses suggestion to affect the person's subconscious

relaxation training, which reduces stress and eases emotional strain

stress management

transcutaneous electrical nerve stimulation, or TENS, which relieves pain by stimulating nerves

What are the side effects of the treatments?

Medicines used to treat migraine may cause drowsiness, allergic reactions, or rebound headache. Rebound headaches are caused by regular use of pain medicines.

What happens after treatment for the condition?

After treatment, the first symptoms of ophthalmoplegic migraine may subside. People sometimes report feeling tired after coping with migraine symptoms.

How is the condition monitored?

Ophthalmoplegic migraines are monitored with ongoing vision tests. These are used to rule out any other type of eye disease. Any new or worsening symptoms should be reported to the healthcare provider.

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