Recurrent painful ophthalmoplegic neuropathy: a case report and literature review

Recurrent painful ophthalmoplegic neuropathy (RPON) is a rare neurological syndrome characterized by recurrent attacks of unilateral headache, accompanied by paresis of one or more ocular motor nerves (most commonly the third cranial nerve, less often the fourth or sixth). This article presents a clinical case of RPON in a young female patient without MRI abnormalities but with elevated inflammatory markers. Pathogenetic mechanisms are discussed based on current literature data. A positive therapeutic effect of methylprednisolone was observed, manifested by regression of oculomotor deficits. Thus, the absence of MRI changes does not necessarily exclude the inflammatory nature of RPON, while a favorable response to corticosteroid therapy supports the role of immune-inflammatory mechanisms in its pathogenesis.