Persistent ocular motor disturbances in migraine without aura

Activation in the brain stem during attacks of migraine has been detected with the use of functional imaging, suggesting an important role of the brain stem in this disorder. Recent findings showed permanent cerebellar signs in common forms of migraine. Both structures are involved in generating smooth pursuit eye movements. The aim of this study was to investigate migraine patients by electrooculography to identify persisting abnormalities that may provide a clinical sign of continuous dysfunction of these structures. We investigated 25 patients with migraine without aura and 15 controls. Smooth pursuit was pathologically changed, velocity gain was reduced and phase was significantly altered in migraineurs as compared to controls. The data provide clinical evidence of a persistent dysfunction in the brain stem and certain cerebellar structures in migraine patients. This is consistent with previous studies indicating an important role of the brain stem in generating migraine attacks.