Journal of Postgraduate Medicine
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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

Correspondence Address:
A Borade
Department of Pediatrics, Amrita Institute of Medical Sciences Elamakkara (P.O), Kochi - 682 026, Kerala
India




How to cite this article:
Borade A, Prabhu A S. Authors' reply.J Postgrad Med 2009;55:231-232


How to cite this URL:
Borade A, Prabhu A S. Authors' reply. J Postgrad Med [serial online] 2009 [cited 2022 May 18 ];55:231-232
Available from: https://www.jpgmonline.com/text.asp?2009/55/3/231/57391


Full Text

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

1Granado LIG, Guillén G. Treatment options for ophthalmoplegic migraine. J Postgrad Med 2009;55:231.
2Borade A, Prabhu AS, Kumar S, Prasad V, Rajam L. Magnetic resonance imaging findings in ophthalmoplegic migraine. J Postgrad Med 2009;55:137-8.
3Bek S, Genc G, Demirkaya S, Eroglu E, Odabasi Z. Ophthalmoplegic migraine. Neurologist 2009;15:147-9.
4Levin M, Ward TN. Ophthalmoplegic migraine. Curr Pain Headache Rep 2004;8:306-9.
5Manzouri 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.

 
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