Ep. Chronicle et Wm. Mulleners, VISUAL-SYSTEM DYSFUNCTION IN MIGRAINE - A REVIEW OF CLINICAL AND PSYCHOPHYSICAL FINDINGS, Cephalalgia, 16(8), 1996, pp. 525-535
This paper reviews both clinical and experimental literature relating
to visual dysfunction in migraine, starting with the eye and progressi
ng via the retina and visual pathways to the visual cortex. Migraine i
s associated with (i) a pupillary sympathetic hypofunction, and (ii) a
cortical hypersensitivity to visual stimuli (perhaps only in migraine
with aura), the pathogenesis of which remains to be determined. Vario
us hypotheses are discussed, and it is proposed that the methods of vi
sual psychophysics may represent a useful approach in the future study
of cortical hyperexcitability in migraine. Paradoxically, little rese
arch has been directed towards understanding (i) the photophobia of mi
graine attacks, and (ii) how migraine may be triggered by visual stimu
li. Research aimed at elucidating the mechanisms of these phenomena ma
y enhance understanding of the pathogenesis of migraine.