Although a recognized migrainous phenomenon in adults, transient oculo
sympathetic paresis in childhood has been rarely observed. Six pediatr
ic patients are reported with transient oculosympathetic paresis occur
ring within the context of characteristic vascular headaches. The clin
ical profiles of the patients suggest transient dysfunction of third-o
rder ocular sympathetic pathways and represent most likely a benign, s
elf-limited variant of pediatric migrainous neuralgia.