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13. CRANIAL NEURALGIAS AND CENTRAL CAUSES OF FACIAL PAIN 13.1. Trigeminal neuralgia 13.2. Glossopharyngeal neuralgia 13.3. Nervus intermedius neuralgia [G51.80] 13.4. Superior laryngeal neuralgia [G52.20] 13.5. Nasociliary neuralgia [G52.80] 13.6. Supraorbital neuralgia [G52.80] 13.7. Other terminal branch neuralgias [G52.80] 13.8. Occipital neuralgia [G52.80] 13.9. Neck-tongue syndrome 13.10. External compression headache 13.11. Cold-stimulus headache 13.12. Constant pain caused by compression, irritation or distortion of cranial nerves or upper cervical roots by structural lesions [G53.8] + [code to specify aetiology] 13.13. Optic neuritis [H46]  13.14. Ocular diabetic neuropathy [E10-E14]  13.15. Head or facial pain attributed to herpes zoster 13.16. Tolosa-Hunt syndrome 13.17. Ophthalmoplegic “migraine” 13.18. Central causes of facial pain 13.19. Other cranial neuralgia or other centrally-mediated facial pain [code to specify aetiology] Bibliography and reference14. OTHER HEADACHE, CRANIAL NEURALGIA, CENTRAL OR PRIMARY FACIAL PAIN 

IHS	Diagnosis	ICD-10
13.17	Ophthalmoplegic “migraine”	G43.80

Description:

Recurrent attacks of headache with migrainous characteristics associated with paresis of one or more ocular cranial nerves (commonly the third nerve) in the absence of any demonstrable intracranial lesion other than MRI changes within the affected nerve.

Diagnostic criteria:

At least 2 attacks fulfilling criterion B
Migraine-like headache accompanied or followed within 4 days of its onset by paresis of one or more of the third, fourth and/or sixth cranial nerves
Parasellar, orbital fissure and posterior fossa lesions ruled out by appropriate investigations

Comment:

This condition is very rare. It is unlikely that 13.17 Ophthalmoplegic "migraine" is a variant of migraine since the headache often lasts for a week or more and there is a latent period of up to 4 days from the onset of headache to the onset of ophthalmoplegia. Furthermore, in some cases MRI shows gadolinium uptake in the cisternal part of the affected cranial nerve which suggests that the condition may be a recurrent demyelinating neuropathy.

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