Erenumab as treatment for recurrent painful ophthalmoplegic neuropathy

Recurrent painful ophthalmoplegic neuropathy (RPON), formerly known as ophthalmoplegic migraine, is a rare condition characterised by recurrent attacks of unilateral headache with ipsilateral ophthalmoplegia. Although classified as a cranial neuralgia, the exact pathophysiology behind RPON is unclear and the clinical presentation often resembles migraine headaches. Here, the authors present the case of a patient with RPON who, after numerous therapeutic failures, received erenumab and experienced significant improvement. This case supports the argument that RPON should be reclassified as a migraine variant, which would enable the use of specific prophylactic medication in patients suffering from this disorder.