Neuro-Ophthalmic Symptoms of Primary Headache Disorders: Why the Patient With Headache May Present to Neuro-Ophthalmology

Smith, Stacy V.

doi:10.1097/wno.0000000000000790

Cited by 10 publications

(3 citation statements)

References 61 publications

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“…Migraineurs can experience a variety of negative or positive visual phenomena, as well as perceptual abnormalities which are not typical of a visual aura [ 13 ]. Blurred vision is the most frequently reported visual manifestation of migraine, with a frequency of 27 to 54.1% in different studies.…”

Section: Discussionmentioning

confidence: 99%

Cranial autonomic symptoms in episodic and chronic migraine: a cross sectional study in Iran

et al. 2021

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Background Cranial autonomic symptoms are common in migraine, with eye redness and tearing being the most common ones. Their identification can help to avoid misdiagnosis, predict the disease course, and select the appropriate treatment. Methods This was a cross-sectional study of 904 patients who presented with migraine to a headache referral clinic. The participants filled out a questionnaire about their headache characteristics, as well as the presence of cranial autonomic symptoms. A total of 904 patients, 698 women (77.2%) and 206 men (22.8%), were included in the study, with a mean (SD) age of 38.05 (11.76) years. Results About 70% of subjects with chronic migraine and 56.2% of those with episodic migraine reported one or more cranial autonomic symptoms. The two most commonly reported autonomic symptoms were eye redness (36.06%) and tearing (21.02%). Chronic migraine (43.4% vs. 29.5%), unilateral headache (56.8% vs. 48.7%), and blurred vision (20% vs. 14.7%) were significantly more frequent in migraineurs with cranial autonomic symptoms. Headache intensity and frequency in subjects with cranial autonomic symptoms were significantly higher than in those without cranial autonomic symptoms. Conclusion We found higher percentages of cranial autonomic symptoms in patients with unilateral headaches, frequent and severe attacks and blurred vision. A diagnosis of cranial autonomic symptoms accompanying migraine may predict more severe disease and the possibility of evolution into chronic migraine.

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Section: Discussionmentioning

confidence: 99%

Cranial autonomic symptoms in episodic and chronic migraine: a cross sectional study in Iran

et al. 2021

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“…Anisocoria may occur in migraine because of either abnormal miosis or mydriasis, indicating an autonomic imbalance between parasympathetic constriction and sympathetic dilation of the pupil. Miosis is the most reported pupillary abnormality, frequently associated to other CAS such as ptosis, due to oculosympathetic hypofunction (17,18).…”

Section: Discussionmentioning

confidence: 99%

Bilateral tonic pupil during a migraine attack: a case report.

Storarri,

Higa Lee,

Renan

2024

Headache Med

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Tonic pupil or Adie's pupil occurs due to parasympathetic denervation, and it is characterized by mydriasis with little or no response to light, with pupillary contraction to accommodation. It is caused by eye pathologies, such as infections, trauma, neoplasms, inflammatory diseases, and systemic diseases with autonomic dysfunction. Few cases have been reported of bilateral tonic pupils associated with migraine attacks. Our aimed to describe the case of a young female patient with a history of chronic migraine without aura, who presented acutely with bilateral pupillary mydriasis during a migraine attack, characterized as tonic pupil, and to discuss the possible causes of mydriasis during a migraine attack.

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“…Most neurologists are familiar with photophobia and visual aura in migraine. However, patients may experience visual disturbances in the form of more complex perceptual abnormalities such as Alice in Wonderland syndrome and visual snow (7). These visual disturbances may consist of positive and/or negative symptoms (8).…”

Section: Introductionmentioning

confidence: 99%

Conjunctival Impression Cytology and Dry Eye Parameters in Migraine Patients

Altaş,

Oltulu,

Belviranlı

et al. 2024

Preprint

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Objective In this study, it was aimed to compare ocular surface changes and dry eye parameters between migraine patients and healthy individuals. Material and Methods The participants of the present cross-sectional comparative study are 30 migraine patients and 31 age and gender matched healthy individuals. The demographic and clinical data of migraine patients were recorded. Ocular surface changes were evaluated using Schirmer I test, tear break-up time (TBUT), Ocular Surface Disease Index (OSDI) scores and conjunctival impression cytology (CIC) grades were assessed and results were compared between the two groups. Results CIC degrees of the migraine patients were higher than the control group (p<0.001). CIC assessment of the migraine group revealed that ten patients (33.3%) were of grade II-III, whereas the CIC assessment of two (6.5%) participants in the control group was grade II. Grade III CIC was not determined in the control group. TBUT in the migraine group was lower compared to the control group (p=0.023) and Schirmer I was (p=0.013) lower and OSDI score higher (p<0.001). In the migraine group, there was an inverse correlation between CIC grade, Schirmer I test (p=0.001, ρ=-0.559) and TBUT (p<0.001, ρ=-0.778). Conclusion Objective signs and subjective symptoms of dry eye are common in patients with migraine. Abnormal CIC evaluation findings such as morphological changes in the bulbar conjunctiva, goblet cell loss, and squamous metaplasia suggest the presence of inflammation. These findings too, support the hypothesis that dry eye and changes in the ocular surface may play a role in the pathogenesis of migraine.

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Neuro-Ophthalmic Symptoms of Primary Headache Disorders: Why the Patient With Headache May Present to Neuro-Ophthalmology

Cited by 10 publications

References 61 publications

Cranial autonomic symptoms in episodic and chronic migraine: a cross sectional study in Iran

Cranial autonomic symptoms in episodic and chronic migraine: a cross sectional study in Iran

Bilateral tonic pupil during a migraine attack: a case report.

Conjunctival Impression Cytology and Dry Eye Parameters in Migraine Patients

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