Dysfunction of the pupillary light reflex following migraine headache

Abstract

Using pupillometry and sympathetic skin responses we compared the changes in local and systemic autonomic function within one week of a migraine attack. We investigated whether the measurement of the pupillary light reflex provides further information on the pathophysiology of migraine.Forty-two migraine patients and forty-two healthy age-matched controls were included. The parameters that were measured were the amplitude of the pupillary light reflex, the pupil size at the beginning of the measurement, the latency, the velocity of constriction and the velocity at the end of the dilatation. The average pupil size was 6.43 mm in the migraine group and 6.7 mm in the control group (p < 0.01). Reduced velocity of constriction and smaller amplitude of constriction in migraine patients within two days of an attack were signs of a parasympathetic dysfunction (p < 0.05). The sympathetic skin response did not differ significantly between migraine sufferers and controls. These findings indicate that both parasympathetic and sympathetic nerves supplying the eye are involved in migraine headache presumably due to effects on the pericarotid sympathetic fibers and involvement of trigeminal-parasympathetic reflexes.

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Immediate effects of a thoracic spine thrust manipulation on the autonomic nervous system: a randomized clinical trial

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Autonomic Function in Migraine Patients: Ictal and Interictal Pupillometry

“…Associated interictal autonomic abnormalities have been documented in these patients including abnormal cardiovascular reflexes to hemodynamic challenges, altered heart rate variation, vascular reactivity, electrodermal activity, and catecholamine levels . Although the literature is not unequivocal, there is a body of evidence supporting the presence of a subtle, general sympathetic hypofunction in migraine patients …”