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Chronic paroxysmal hemicrania. XIII. The pupillometric pattern
D Souza Souza Carvalho1, R Salvesen, T Sand
1Department of Neurology, Regionsykehuset, Trondheim University Hospital, Norway.
Cephalalgia : an International Journal of Headache
|September 1, 1988
Summary
Pupillometric and sweating tests reveal distinct patterns in chronic paroxysmal hemicrania (CPH) compared to cluster headaches. These findings aid in differentiating the two headache disorders and understanding their unique pathogenesis.
Area of Science:
- Neurology
- Ophthalmology
- Pain Medicine
Background:
- Chronic paroxysmal hemicrania (CPH) is a distinct headache disorder.
- Understanding the pathophysiology of CPH is crucial for diagnosis and treatment.
- Previous studies suggest potential differences between CPH and cluster headache.
Purpose of the Study:
- To investigate pupillometric and forehead sweating patterns in patients with CPH.
- To compare these patterns with those of age- and sex-matched controls.
- To explore the potential of these tests in differentiating CPH from cluster headache.
Main Methods:
- Pupillometric measurements were performed on CPH patients and controls under basal conditions and after pharmacological stimulation (tyramine, OH-amphetamine, phenylephrine).
- Forehead sweat gland function was assessed using evaporimetry with body heating and pilocarpine tests.
- Data were analyzed to compare symptomatic and non-symptomatic sides in CPH patients against controls.
Main Results:
- CPH patients exhibited significantly smaller pupils in the basal state compared to controls, especially on the symptomatic side.
- Mydriatic responses to pharmacological agents were similar between symptomatic and non-symptomatic sides in CPH patients.
- Forehead sweating patterns were symmetrical in CPH patients, contrasting with findings in cluster headache.
Conclusions:
- Pupillometric and forehead sweating findings in CPH differ from those observed in cluster headache.
- These physiological tests may serve as valuable tools for clinically distinguishing between CPH and cluster headache.
- The results suggest distinct pathophysiological mechanisms underlying CPH and cluster headache.