Abstract
Purpose
The aim of this report is to increase awareness of a possible association between cranial nerve paresis and the use of sumatriptan in migraine sufferers, particularly in patients who have additional vascular risk factors.
Patients and methods
We describe a series of three cases where third nerve paresis developed in patients who were treated with the oral form of sumatriptan. All of the patients had a clear history of repetitive migraine headache and none of them had previous third nerve paresis.
Conclusion
Among a variety of medications for the treatment of migraine, there are some drugs with vasoconstrictive effects, particularly triptans. These drugs may be a contributing factor for microvascular damage of the cranial nerves and other organs.
Similar content being viewed by others
Log in or create a free account to read this content
Gain free access to this article, as well as selected content from this journal and more on nature.com
or
References
Tamhankar MA, Biousse V, Ying GS, Prasad S, Subramanian PS, Lee MS et al. Isolated third, fourth, and sixth cranial nerve palsies from presumed microvascular versus other causes: a prospective study. Ophthalmology 2013; 120 (11): 2264–2269.
Tamhankar MA, Volpe NJ . Management of acute cranial nerve 3, 4 and 6 palsies: role of neuroimaging. Curr Opin Ophthalmol 2015; 26 (6): 464–468.
Sadagopan KA, Wasserman BN . Managing the patient with oculomotor nerve palsy. Curr Opin Ophthalmol 2013; 24 (5): 438–447.
Bek S, Genc G, Demirkaya S, Eroglu E, Odabasi Z . Ophthalmoplegic migraine. Neurologist 2009; 15 (3): 147–149.
Asghar MS, Hansen AE, Amin FM, van der Geest RJ, Koning P, Larsson HB et al. Evidence for a vascular factor in migraine. Ann Neurol 2011; 69 (4): 635–645.
Chan KY, Labruijere S, Ramirez Rosas MB, de Vries R, Garrelds IM, Danser AH et al. Cranioselectivity of sumatriptan revisited: pronounced contractions to sumatriptan in small human isolated coronary artery. CNS Drugs 2014; 28 (3): 273–278.
Triptans: beware of vasoconstrictive effects. Prescrire Int 2014; 23 (153): 240.
Hodge JA, Hodge KD . Ischemic colitis related to sumatriptan overuse. J Am Board Fam Med 2010; 23 (1): 124–127.
Nguyen TQ, Lewis JH . Sumatriptan-associated ischemic colitis: case report and review of the literature and FAERS. Drug Saf 2014; 37 (2): 109–121.
Repaka A, Wenger J, Sitaraman SV . A case of sumatriptan-induced intestinal ischemia. J Gastroenterol 2006; 41 (2): 177–178.
Rothner AD, Winner P, Nett R, Asgharnejad M, Laurenza A, Austin R et al. One-year tolerability and efficacy of sumatriptan nasal spray in adolescents with migraine: results of a multicenter, open-label study. Clin Ther 2000; 22 (12): 1533–1546.
Sharma SG, Post JB, Herlitz LC, Markowitz G . Renal cortical infarction following treatment with sumatriptan in a kidney allograft recipient. Am J Kidney Dis 2013; 61 (2): 326–329.
Hossein GC, Chane M, Sadun AA . Ocular motility problems associated with sumatriptan administration. Ann Ophthalmol 2001; 33 (Suppl 3): 231–232.
Winner P, Rothner AD, Saper J, Nett R, Asgharnejad M, Laurenza A et al. A randomized, double-blind, placebo-controlled study of sumatriptan nasal spray in the treatment of acute migraine in adolescents. Pediatrics 2000; 106 (5): 989–997.
Wilkinson M, Pfaffenrath V, Schoenen J, Diener HC, Steiner TJ . Migraine and cluster headache—their management with sumatriptan: a critical review of the current clinical experience. Cephalalgia 1995; 15 (5): 337–357.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Competing interests
The authors declare no conflict of interest.
Rights and permissions
About this article
Cite this article
Novitskaya, E., Cates, C., Bowes, O. et al. Triptans and third nerve paresis: a case series of three patients. Eye 31, 503–505 (2017). https://doi.org/10.1038/eye.2016.256
Received:
Accepted:
Published:
Issue date:
DOI: https://doi.org/10.1038/eye.2016.256
This article is cited by
-
Sumatriptan
Reactions Weekly (2017)
