(1) True oculomotor paralysis migraine: There is typical unilateral throbbing pain or throbbing headache, and the attack lasts for several hours to several days. Ophthalmic muscle palsy is often a palsy of the motoneurone nerve, but palsy of the talocrural nerve and spider nerve is rare. Angiography and CT scan are normal, so cavernous sinus aneurysm and other organic diseases can be excluded. (2) Symptomatic oculomotor paralysis migraine: It refers to migraine caused by occupying lesion in cavernous sinus, especially aneurysm. 2. Clinical characteristics (1) Migraine: It appears before oculomotor paralysis, and the headache is mostly located in the unilateral frontal top, frontotemporal or frontal orbital area. The nature of the headache is paroxysmal throbbing pain or throbbing pain, often accompanied by nausea and vomiting. (2) Ophthalmic muscle paralysis: Ophthalmic muscle paralysis occurs after migraine, often involving the third cerebral nerve, manifesting as complete motoneuropathy, with drooping eyelids, outward and downward eyeballs, and obvious limitation of upward, downward and inward eye movements, accompanied by dilated pupils; it may also involve the sixth cerebral nerve, but rarely invades the fourth cerebral nerve. (3) The eye movement disorder is aggravated when migraine is relieved: if both the IV and VI cerebral nerves are involved, the eye is fixed. (4) Headache, nausea, vomiting and ocular muscle palsy can last from a few hours to 10 weeks, mostly in one eye, but also in both eyes or alternately. (5) Eye muscle palsy is temporary, but can be recurrent, with the number of episodes ranging from 2 to 4 or more. The interval between attacks varies little and can be several days or years, and the higher the frequency of recurrence, the shorter the interval. (6) Taking vasodilators is effective. Oculomotor paralysis migraine is not common clinically, and the diagnosis can be made based on the main features of migraine, oculomotor paralysis, recurrent attacks and no obvious organic lesions on clinical examination.