OCULOSYMPATHETIC ALTERATIONS IN MIGRAINE PATIENTS

Oculosympathetic function was studied in 20 headache-free migraine pat ients and in 20 controls. Pupillary investigation was performed under basal conditions, and after instillation of tyramine (2%) and phenylep hrine (1%) eyedrops. Each test was performed twice shortly after a spo ntaneous attack and then repeated after 7 and 15 days. In the patients , the normal mydriatic response induced by tyramine was significantly (p<0.001) reduced and phenylephrine instillation caused a significant (p<0.01) pupillary dilatation in both the assessments performed shortl y after the attack. These abnormal responses were bilateral in all pat ients and slightly anisocoric in some. They were significantly (p<0.00 1) more pronounced in the patients who had pain and pronounced vascula r features. The reduced oculosympathetic response to ts?amine, as well as the hypersensitivity to phenylephrine, was less evident 7 days aft er the attack and absent after 15 days. A transient and bilateral post -ganglionic oculosympathetic hypofunction, with adrenoceptor hypersens itivity, was found to be temporally related to the migraine attack, re gardless of the side or predominant side of pain.