Which neurological exam findings are characteristic of migraine variants (equivalents)?

Updated: Oct 16, 2019
  • Author: Rima M Dafer, MD, MPH, FAHA; Chief Editor: Helmi L Lutsep, MD  more...
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Answer

Answer

Interictally, the neurologic examination is nonfocal. Ictally, hemiparesis, ophthalmoplegia, or altered consciousness may be observed. Abnormalities of the oculomotor nerve with pupillary involvement are seen in ophthalmoplegic migraine, followed by abnormalities of the abducens and, less commonly, the trochlear nerve. Children with abdominal migraine or cyclic vomiting may show subtle clumsiness, attention deficit, or development delay.

In migrainous infarction, some form of neurologic deficit with abnormal neuroimaging is present. Rarely, when patients with retinal migraine are evaluated and examined during an attack of visual loss, optic pallor or narrowing of the retinal vessels can be seen.


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