Orbital Myositis Posing as Cluster Headache
Michael S. Lee, MD;
Simmons Lessell, MD
Arch Neurol. 2002;59:635-636.
Objective To describe the case of a patient with recurrent orbital myositis who
was thought to have cluster headaches for 6 years.
Design and Setting Case report in an outpatient neuro-ophthalmology clinic.
Patient A 24-year-old man developed unilateral supraorbital pain, lacrimation,
conjunctival hyperemia, nasal congestion, proptosis, and painful eye movements.
The pain intensity varied over the course of each day and disappeared after
1 month. He had multiple attacks responsive to prednisone that were separated
by months over the ensuing 6 years. Neuroimaging revealed an enlarged extraocular
muscle.
Conclusions Overlap in symptoms between recurrent orbital myositis and cluster headache
delayed the diagnosis in this patient. Orbital myositis should be considered
in patients with atypical cluster headache characterized by proptosis, painful
eye movements, and pain that does not completely resolve after 3 hours.
From the Department of Neuro-ophthalmology, Massachusetts Eye and Ear
Infirmary, Harvard University Medical School, Boston.
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