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Recurrent painful ophthalmoplegic neuropathy , previously known as ophthalmoplegic migraine , is a rare neurological disorder that is characterized by repeated headache attacks and reversible ipsilateral paresis of one or more ocular cranial nerves. Oculomotor nerve is by far the most common cranial nerve involves in RPON, while abducens nerve and trochlear nerve involvements are also reported. Globally, RPON was estimated to have an annual incidence rate of 0.7 per million as of 1990, no further epidemiological studies have been conducted. It occurs more often in children and females.
Although the etiology of RPON is unknown owing to the rarity of this disease, various potential theories including migrainous and neuropathic mechanisms have been developed. Diagnosis is based on physical examination, magnetic resonance imaging , and ruling out other possible causes. Despite the fact that there are currently no evidence-based treatment guidelines for RPON, the most commonly used medications are corticosteroids that have been proven effective in alleviating the symptoms. As for people who are unresponsive to steroids, other treatments, such as anti-migraine drugs, botulinum toxin injection and strabismus surgery, may be utilized. For prevention, several medications including calcium channel blockers may be used. However, none have been proved consistently effective. RPON has a good overall prognosis as a result of the self-limiting nature of the condition, but permanent neurological damage may accumulate over repeated episodes.