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Dysfunction of the sympathetic nervous system in cluster headache
1Department of Neurology, Prince Henry Hospital, Sydney, N.S.W., Australia.
Cephalalgia : an International Journal of Headache
|September 1, 1988
Summary
Cluster headache patients show persistent ocular sympathetic deficits, even between attacks. This suggests ongoing impairment of sympathetic nerve function on the affected side, particularly in the cervical region.
Area of Science:
- Neurology
- Ophthalmology
- Autonomic Nervous System Research
Background:
- Cluster headache is a debilitating neurological disorder characterized by severe unilateral head pain.
- Ocular autonomic dysfunction is often observed during cluster headache attacks.
Purpose of the Study:
- To investigate persistent ocular sympathetic function in cluster headache patients during remission.
- To determine the nature and extent of sympathetic deficits between cluster headache attacks.
Main Methods:
- Studied 13 cluster headache patients during and between attacks.
- Assessed pupillary response to tyramine eyedrops.
- Evaluated facial sweating and flushing in response to body heating and chili ingestion during remission.
Main Results:
- Pupillary dilatation lag persisted on the symptomatic side between attacks, correlating with reduced forehead sweating.
- Six patients showed impaired pupillary dilatation to tyramine eyedrops during remission.
- Five patients exhibited no signs of ocular sympathetic deficit between attacks.
Conclusions:
- Incomplete sympathetic deficit persists in a subgroup of cluster headache patients during remission.
- The observed deficits are often consistent with impaired postganglionic cervical sympathetic fibers.
- Ocular sympathetic dysfunction may be a long-term consequence of cluster headache.