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Related Experiment Videos

Ciliospinal reflex response in cluster headache

U Havelius1, M Heuck, P Milos

  • 1Department of Neurology, University Hospital MAS, Lund University, Malmö, Sweden.

Headache
|October 1, 1996
PubMed
Summary
This summary is machine-generated.

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Cluster headache patients, especially those with Horner-like syndrome, show reduced ciliospinal reflex responses, indicating sympathetic nervous system dysfunction is key to cluster headache pathophysiology.

Area of Science:

  • Neurology
  • Ophthalmology
  • Pain Medicine

Background:

  • The ciliospinal reflex (CSR) involves sympathetic nerves controlling pupillary dilation.
  • Pupillary responses in cluster headache (CH) suggest sympathetic dysfunction.
  • A subset of CH patients presents with Horner-like syndrome (miosis, ptosis).

Purpose of the Study:

  • To investigate CSR in cluster headache patients.
  • To determine if CSR abnormalities differentiate CH subgroups.
  • To explore the role of sympathetic dysfunction in CH pathophysiology.

Main Methods:

  • Studied CSR in 25 CH patients and controls.
  • Assessed pupillary responses to phenylephrine and tyramine.
  • Correlated CSR findings with clinical presentation, including Horner-like syndrome.

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Main Results:

  • CH patients with Horner-like syndrome had significantly reduced CSR on the symptomatic side compared to controls and CH patients without Horner-like syndrome.
  • Reduced CSR was also observed on the non-symptomatic side in patients with Horner-like syndrome.
  • 18/25 (72%) CH patients showed asymmetric CSR, often reduced on the symptomatic side.

Conclusions:

  • Patients with Horner-like syndrome represent a distinct subgroup of cluster headache.
  • The Horner-like syndrome in CH is linked to postganglionic sympathetic nerve dysfunction.
  • Findings support the involvement of cephalic sympathetic nervous system dysfunction in cluster headache pathophysiology.