MRI using gadolinium contrast material can demonstrate lesions in cran
ial nerves. Tumors and inflammatory lesions have been described.1,2 Th
ere is little published information on MRI of cranial nerves in patien
ts with migraine headaches with ophthalmoplegia.3 We present a case of
ophthalmoplegic migraine with a cranial nerve abnormality which was s
ubsequently shown to improve as the patient clinically improved. Impli
cations from this finding are discussed in relation to the pathophysio
logy of ophthalmoplegic migraine.