Recurrent ocular nerve palsy in childhood - long-time observation

Background The underlying pathology of recurrent IIIrd (and VIth) Nerve pal sy are often unknown. Long-term observation sometimes reveal surprising cau ses. Patient At the first presentation in the clinic the patient was 5 years old and suffered from the second episode of the palsy (which regressed quickly ). Two recurrences followed in intervals of 1 to 2 years, the first lasted for days, the second for months. In the last palsy transient synkinesis of the upper lid was seen. Three of the four events were preceded by gastroint estinal or respiratory infection. Pediatric and neurological findings and N MR were normal. Later,the girl suffered from migraine with gastrointestinal involvement. Conclusion Migraine can be masked by gastrointestinal or respiratory infect ion.