Common Causes Of Ophthalmoplegia

Migraines

Recurrent headaches and ophthalmoplegia can cause a rare neurological condition known as ophthalmoplegic migraines. These are different from other types of headaches, which characteristically have a visual aura. MRI findings have shown migraines have an inflammatory cranial neuropathy. MIgraines will typically present with a transient headache and double vision and a drooping upper eyelid. These types of headaches have been found to usually occur in children, but they have also been reported in adults. Symptoms tend to resolve after an episode, unless the episodes are persistent, in which case some deficits remain. There is still no adequate treatment for migraines, but some doctors have recommended prophylactic medications, such as beta blockers or calcium channel blockers.

Multiple Sclerosis

Patients with multiple sclerosis, a condition in which the immune system destroys the nerves' protective covering, may also present with intranuclear ophthalmoplegia. Multiple sclerosis generally affects younger individuals and causes intranuclear ophthalmoplegia in both eyes. In this condition, the nerve fibers that coordinate the horizontal movements of the eyes become damaged, leading to blurry vision since both eyes cannot focus on the same object.

This impaired horizontal eye movement is due to a lesion in the medial longitudinal fasciculus, which is what causes the eyes not to be able to gaze laterally. Many brainstem syndromes can affect the medial longitudinal fasciculus, but multiple sclerosis is the most common cause of impaired horizontal movements of the eye. In the case of an acute intranuclear ophthalmoplegia, intravenous steroids can be given to the patient.