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LETTER
Year : 2009  |  Volume : 55  |  Issue : 3  |  Page : 231-232

Authors' reply


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

Date of Web Publication2-Nov-2009

Correspondence Address:
A Borade
Department of Pediatrics, Amrita Institute of Medical Sciences Elamakkara (P.O), Kochi - 682 026, Kerala
India
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Source of Support: None, Conflict of Interest: None


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How to cite this article:
Borade A, Prabhu A S. Authors' reply. J Postgrad Med 2009;55:231-2

How to cite this URL:
Borade A, Prabhu A S. Authors' reply. J Postgrad Med [serial online] 2009 [cited 2019 Jul 22];55:231-2. Available from: http://www.jpgmonline.com/text.asp?2009/55/3/231/57391


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 Top

1.Granado LIG, Guillén G. Treatment options for ophthalmoplegic migraine. J Postgrad Med 2009;55:231.  Back to cited text no. 1    Medknow Journal  
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.  Back to cited text no. 2  [PUBMED]  Medknow Journal  
3.Bek S, Genc G, Demirkaya S, Eroglu E, Odabasi Z. Ophthalmoplegic migraine. Neurologist 2009;15:147-9.  Back to cited text no. 3  [PUBMED]  [FULLTEXT]  
4.Levin M, Ward TN. Ophthalmoplegic migraine. Curr Pain Headache Rep 2004;8:306-9.  Back to cited text no. 4  [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.   Back to cited text no. 5  [PUBMED]  [FULLTEXT]  




 

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Online since 12th February '04
2004 - Journal of Postgraduate Medicine
Official Publication of the Staff Society of the Seth GS Medical College and KEM Hospital, Mumbai, India
Published by Wolters Kluwer - Medknow