Cranial Autonomic Symptoms in Migraine: An Observational Study

Area of Science:

• Neurology
• Ophthalmology
• Autonomic Nervous System Disorders

Background:

• Migraine headaches can be accompanied by systemic autonomic symptoms.
• Cranial autonomic symptoms (CAS) are primarily indicative of trigeminal autonomic cephalalgias (TACs).
• Existing literature reports a wide prevalence of CAS in migraine patients, ranging from 26% to 80%.

Purpose of the Study:

• To determine the frequency of cranial autonomic symptoms (CAS) in migraine patients.
• To investigate the relationship between CAS and headache laterality in migraineurs.
• To identify other potential factors associated with CAS in migraine.

Main Methods:

• A cohort of 200 consecutive migraine patients from a headache clinic was studied.
• Presence and characteristics of CAS (ocular, nasal, facial, aural) were recorded.
• Headache laterality and triggers were documented using ICHD-3 (beta version) criteria.

Main Results:

• 148 (74%) of 200 migraine patients reported at least one CAS; 70% had two or more.
• Common CAS included lacrimation (45.5%), conjunctival injection (34.5%), and eyelid edema (34%).
• Bilateral CAS occurred in 87% of affected patients, with sunlight identified as a trigger in all CAS-positive cases.

Conclusions:

• Cranial autonomic symptoms are a frequent occurrence in migraine patients.
• CAS in migraine are predominantly bilateral.
• Sunlight is a significant trigger for headache in migraine patients with CAS.