Publicação
Recurrent Painful Ophthalmoplegic Neuropathy: A Diagnostic Challenge in the Pediatric Age
| Resumo: | Recurrent painful ophthalmoplegic neuropathy (RPON) is a rare clinical entity, whose pathophysiology is not well understood. We present the case of a girl who, at 14 months of age, suddenly started right eyelid ptosis and incomplete paresis of the ipsilateral oculomotor nerve. Magnetic resonance imaging revealed a thickening of the emergence of that nerve. She was treated with corticosteroids and, over the years, presented multiple similar episodes, concluding with the diagnosis of RPON. The second case involves a 17-year-old girl with a history of episodic migraine and asymptomatic SARS-CoV-2 infection, also with right palpebral ptosis, with rapid progression to incomplete paresis of the ipsilateral oculomotor nerve. Ocular myasthenia gravis, a cranial neuralgia associated with COVID-19, and RPON were considered as hypotheses, with no recurrences to date. RPON recognition is difficult. This situation may contribute to its underestimation of prevalence, particularly in children. |
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| Autores principais: | Camacho Sampaio, Margarida |
| Outros Autores: | Coimbra Queirós, Henrique; Palavra, Filipe; Pais, Rui Pedro; Paiva, Catarina; Costa, Carmen |
| Assunto: | Child Ophthalmoplegia/diagnosis Ophthalmoplegic Migraine/ diagnosis Ophthalmoplegic Migraine/ drug therapy Criança Oftalmoplegia/diagnóstico Enxaqueca Oftalmoplégica/ diagnóstico Enxaqueca Oftalmoplégica/ tratamento farmacológico |
| Ano: | 2024 |
| País: | Portugal |
| Tipo de documento: | artigo |
| Tipo de acesso: | unknown |
| Instituição associada: | Sociedade Portuguesa de Neurologia |
| Idioma: | português |
| Origem: | SINAPSE |
| Resumo: | Recurrent painful ophthalmoplegic neuropathy (RPON) is a rare clinical entity, whose pathophysiology is not well understood. We present the case of a girl who, at 14 months of age, suddenly started right eyelid ptosis and incomplete paresis of the ipsilateral oculomotor nerve. Magnetic resonance imaging revealed a thickening of the emergence of that nerve. She was treated with corticosteroids and, over the years, presented multiple similar episodes, concluding with the diagnosis of RPON. The second case involves a 17-year-old girl with a history of episodic migraine and asymptomatic SARS-CoV-2 infection, also with right palpebral ptosis, with rapid progression to incomplete paresis of the ipsilateral oculomotor nerve. Ocular myasthenia gravis, a cranial neuralgia associated with COVID-19, and RPON were considered as hypotheses, with no recurrences to date. RPON recognition is difficult. This situation may contribute to its underestimation of prevalence, particularly in children. |
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