Recurrent Painful Ophthalmoplegic Neuropathy: A Diagnostic Challenge in the Pediatric Age

Authors

  • Margarida Camacho Sampaio Centro de Desenvolvimento da Criança – Neuropediatria / Centro Hospilatar e Universitário de Coimbra, Coimbra, Portugal https://orcid.org/0009-0009-4576-5262
  • Henrique Coimbra Queirós Serviço de Imagem Médica – Unidade de Neurorradiologia / Centro Hospilatar e Universitário de Coimbra, Coimbra, Portugal https://orcid.org/0000-0002-6891-8403
  • Filipe Palavra Centro de Desenvolvimento da Criança – Neuropediatria / Centro Hospilatar e Universitário de Coimbra, Coimbra, Portugal; Laboratório de Farmacologia e Terapêutica Experimental, Instituto de Investigação Clínica e Biomédica de Coimbra (iCBR), Faculdade de Medicina, Universidade de Coimbra, Coimbra, Portugal; Centro Académico Clínico de Coimbra, Coimbra, Portugal https://orcid.org/0000-0002-2165-130X
  • Rui Pedro Pais Serviço de Imagem Médica – Unidade de Neurorradiologia / Centro Hospilatar e Universitário de Coimbra, Coimbra, Portugal
  • Catarina Paiva Serviço de Oftalmologia – Unidade de Oftalmologia Pediátrica / Centro Hospilatar e Universitário de Coimbra, Coimbra, Portugal
  • Carmen Costa Centro de Desenvolvimento da Criança – Neuropediatria / Centro Hospilatar e Universitário de Coimbra, Coimbra, Portugal

DOI:

https://doi.org/10.46531/sinapse/CC/230059/2024

Keywords:

Child, Ophthalmoplegia/diagnosis, Ophthalmoplegic Migraine/ diagnosis, Ophthalmoplegic Migraine/ drug therapy

Abstract

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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Published

2024-04-04

How to Cite

1.
Camacho Sampaio M, Coimbra Queirós H, Palavra F, Pais RP, Paiva C, Costa C. Recurrent Painful Ophthalmoplegic Neuropathy: A Diagnostic Challenge in the Pediatric Age. Sinapse [Internet]. 2024 Apr. 4 [cited 2024 May 16];24(1):33-8. Available from: https://sinapse.pt/index.php/journal/article/view/47

Issue

Vol. 24 No. 1 (2024): January-March

Section

Case Reports

License

Copyright (c) 2024 Margarida Camacho Sampaio, Henrique Coimbra Queirós, Filipe Palavra, Rui Pedro Pais, Catarina Paiva, Carmen Costa

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

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