Brain, Vol 120, Issue 10 1857-1864, Copyright © 1997 by Oxford University Press
PD Drummond
Subjective and autonomic responses to visual stimulation and facial pain
were investigated in 10 migraine sufferers and 21 'non-headache' control
subjects. Ratings of glare- and light-induced pain were greater in migraine
sufferers than control subjects. In migraine sufferers, glare ratings
increased during painful mechanical stimulation of the nasal ala, the side
of the nose and the back of the neck. Glare ratings decreased in both
groups during painful stimulation of the chin. Light- induced pain
increased during painful stimulation of all four sites in migraine
sufferers, but not control subjects. Increases in forehead pulse amplitude
during painful mechanical stimulation were greater bilaterally in migraine
sufferers than in control subjects, consistent with loss of inhibitory
influences on vascular reactions in the face. Visual stimulation
facilitated lacrimation when the nasal ala was pinched, but visual
stimulation coupled with pain elsewhere in the head and neck did not. The
lacrimal response to combined nasal ala and visual stimulation was absent
on the symptomatic side in patients with unilateral headache, indicating
local parasympathetic deficit in migraine. These findings suggest that
migraine is associated with loss of inhibitory subcortical processes which
normally suppress sensations of glare and light-induced pain, and which may
also suppress vasodilator responses to facial pain. Loss of inhibitory
pain-control mechanisms could interact in a vicious circle with autonomic
disturbances during migraine.
ARTICLES
Photophobia and autonomic responses to facial pain in migraine
Division of Psychology, Murdoch University, Australia.
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