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| Year : 2009 | Volume
: 55
| Issue : 3 | Page : 231-232 |
Authors' reply
A Borade, AS Prabhu
Department of Pediatrics, Amrita Institute of Medical Sciences Elamakkara (P.O), Kochi - 682 026, Kerala, India
| Date of Web Publication | 2-Nov-2009 |
Correspondence Address:
A Borade
Department of Pediatrics, Amrita Institute of Medical Sciences Elamakkara (P.O), Kochi - 682 026, Kerala
India
 Source of Support: None, Conflict of Interest: None  | Check |
How to cite this article:
Borade A, Prabhu A S. Authors' reply. J Postgrad Med 2009;55:231-2 |
Sir,
We thank Drs. Granado and Guillén for their comments [1] on our article [2] on opthaloplegic migraine (OPM) is a rare variant of migraine seen most commonly in children and presents with palsy of third, fourth or sixth cranial nerves. The phenomenon was considered to be secondary to a microvascular, ischemic etiology. However, recently it has been reclassified as a demyelinating condition. [3] Even optimal treatment of OPM remains unclear. Calcium channel blocking drugs such as verapamil or beta-blocking drugs such as propranolol have been tried in patients with frequent attacks. However, efficacy remains unproven. Steroids have been used with mixed results. [4]
Usually the ophthalmoplegia is a transient phenomenon. For a longstanding or permanent ophthalmoplegia, one can definitely consider using botulinum toxin A or surgical intervention.
Manzouri et al. described patients with OPM and longlasting sixth nerve palsies, in whom botulinum toxin and squint surgery were found to be useful. [5] However, sufficient data is not available to recommend this on a routine basis. We also agree that worldwide large observational studies are required, so as to avoid the longlasting morbidity due to OPM.
| :: References | |  |
| 1. | Granado LIG, Guillén G. Treatment options for ophthalmoplegic migraine. J Postgrad Med 2009;55:231.   |
| 2. | Borade A, Prabhu AS, Kumar S, Prasad V, Rajam L. Magnetic resonance imaging findings in ophthalmoplegic migraine. J Postgrad Med 2009;55:137-8. [PUBMED] |
| 3. | Bek S, Genc G, Demirkaya S, Eroglu E, Odabasi Z. Ophthalmoplegic migraine. Neurologist 2009;15:147-9. [PUBMED] [FULLTEXT] |
| 4. | Levin M, Ward TN. Ophthalmoplegic migraine. Curr Pain Headache Rep 2004;8:306-9. [PUBMED] [FULLTEXT] |
| 5. | Manzouri B, Sainani A, Plant G, Lee J, Sloper J. The aetiology and management of long-lasting sixth nerve palsy in ophthalmoplegic migraine. Cephalalgia 2007;27:275-8. [PUBMED] [FULLTEXT] |
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