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Oculosympathetic alterations in migraine patients
M De Marinis1, S Assenza, F Carletto
1Department of Neurological Sciences, La Sapienza University, Rome, Italy.
Cephalalgia : an International Journal of Headache
|April 9, 1998
Summary
Migraine attacks temporarily impair oculosympathetic function, causing reduced response to tyramine and increased response to phenylephrine eyedrops. This ocular autonomic dysfunction resolves within 15 days post-attack.
Area of Science:
- Neurology
- Ophthalmology
- Autonomic Neuroscience
Background:
- Migraine is a complex neurological disorder often accompanied by autonomic symptoms.
- Oculosympathetic function, controlling pupillary response, has not been fully characterized in migraine patients.
Purpose of the Study:
- To investigate oculosympathetic function in migraine patients.
- To assess pupillary responses to pharmacologic stimulation after a migraine attack.
Main Methods:
- Oculosympathetic function was assessed in 20 migraine patients and 20 controls.
- Pupillary responses to tyramine and phenylephrine eyedrops were measured under basal conditions and at intervals post-migraine attack (shortly after, 7 days, 15 days).
Main Results:
- Migraine patients exhibited a significantly reduced mydriatic response to tyramine and hypersensitivity (pupillary dilation) to phenylephrine shortly after an attack.
- These abnormal pupillary responses were bilateral, temporally related to the migraine attack, and resolved by 15 days.
- Responses were more pronounced in patients with significant pain and vascular features.
Conclusions:
- A transient, bilateral post-ganglionic oculosympathetic hypofunction with adrenoceptor hypersensitivity is associated with migraine attacks.
- This ocular autonomic dysfunction is temporary, resolving within two weeks post-migraine.