Pupillary reactivity in children with recurrent abdominal pain
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P A Battistella1, S Carrà, M Zaninotto
1Department of Pediatrics, University of Padua, Italy.
Insights
Children with recurrent abdominal pain (RAP) showed greater iris dilation after phenylephrine eye drops compared to controls. This suggests a potential sympathetic nervous system dysfunction in RAP patients.
Area of Science:
- Ophthalmology
- Pediatrics
- Neurology
Background:
- Recurrent abdominal pain (RAP) is a common condition in children.
- Sympathetic nervous system dysfunction has been implicated in conditions like migraine.
- Iris receptor sensitivity may reflect systemic autonomic function.
Purpose of the Study:
- To investigate iris dilator muscle response to phenylephrine in children with RAP.
- To explore potential links between RAP and sympathetic nervous system activity.
- To compare pupillary responses in RAP patients versus healthy controls.
Main Methods:
- Electronic pupillometry was used to measure pupillary diameter.
- Phenylephrine eye drops were instilled in the right eye of participants.
- Pupillary response was assessed before and after phenylephrine administration.
- 18 children with RAP (aged 10-16) and 15 age-matched controls were studied.
Main Results:
- Baseline pupillary diameter was similar between RAP patients and controls.
- Iris dilation after phenylephrine was greater in RAP patients than in controls.
- This difference in dilation was not statistically significant.
Conclusions:
- Children with RAP may have altered iris neuromuscular junction receptor sensitivity.
- Findings suggest a possible sympathetic hypofunction in children with RAP.
- This sympathetic hypofunction might be similar to that observed in migrainous patients.
Abstract:
Electronic pupillometry before and after phenylephrine instillation in the right eye was carried out in 18 children aged 10 to 16 years suffering from recurrent abdominal pain (RAP) and 15 age-matched controls. Before stimulation the pupillary diameter was almost equal in the two groups. After phenylephrine eye drops iris dilatation was greater in RAP patients than in controls, even though the difference was not statistically significant. These results seem to suggest children with RAP have a chronically disturbed receptor sensitivity in their iris neuromuscular junction caused by a sympathetic hypofunction, similar to that already reported in migrainous patients.