Question:
Ophthalmoplegic migraine is defined by which one of the following?
Ophthalmoplegic migraine is defined by which one of the following?
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Think of every nerve that moves the eye: III, IV and VI, transiently and recurrently.
Updated On: Jun 24, 2026
- Headache with irreversible loss of ophthalmic nerve function
- Recurrent transient 3rd nerve palsy associated with headache
- Recurrent transient 3rd, 4th and 6th nerve palsy associated with headache
- Headache with optic neuritis
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The Correct Option is C
Solution and Explanation
Step 1: Define the condition. Ophthalmoplegic migraine, now classified as recurrent painful ophthalmoplegic neuropathy, is repeated bouts of headache accompanied by paresis of one or more ocular motor cranial nerves.
Step 2: Identify the nerves involved. The ocular motor nerves are the third (oculomotor), fourth (trochlear) and sixth (abducens). Any of these can be transiently affected, producing diplopia and extraocular muscle weakness during or after the headache.
Step 3: Emphasise the reversibility. The ophthalmoplegia is recurrent and transient, recovering between attacks, which distinguishes it from a structural lesion.
Step 4: Reject the other options. Irreversible nerve loss is against the recurrent transient nature of the disease. Restricting it to the 3rd nerve alone is incomplete because the 4th and 6th can also be involved. Optic neuritis affects the optic (2nd) nerve and vision, not ocular motility.
Step 5: Conclude. The best definition is recurrent transient 3rd, 4th and 6th nerve palsy associated with headache.
Step 2: Identify the nerves involved. The ocular motor nerves are the third (oculomotor), fourth (trochlear) and sixth (abducens). Any of these can be transiently affected, producing diplopia and extraocular muscle weakness during or after the headache.
Step 3: Emphasise the reversibility. The ophthalmoplegia is recurrent and transient, recovering between attacks, which distinguishes it from a structural lesion.
Step 4: Reject the other options. Irreversible nerve loss is against the recurrent transient nature of the disease. Restricting it to the 3rd nerve alone is incomplete because the 4th and 6th can also be involved. Optic neuritis affects the optic (2nd) nerve and vision, not ocular motility.
Step 5: Conclude. The best definition is recurrent transient 3rd, 4th and 6th nerve palsy associated with headache.
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