Brain Advance Access originally published online on January 28, 2004
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Brain, Vol. 127, No. 3, 526-534, 2004
© 2004 Guarantors of Brain
doi: 10.1093/brain/awh061
Facial pain increases nausea and headache during motion sickness in migraine sufferers
School of Psychology, Murdoch University, Western Australia, Australia
Correspondence to: Dr Peter Drummond, School of Psychology, Murdoch University, 6150 Western Australia, Australia E-mail: drummond{at}central.murdoch.edu.au
The aim of this study was to determine whether trigeminal nerve discharge associated with painful stimulation of the temple would intensify symptoms of motion sickness in migraine sufferers. If so, this would support the notion that symptoms such as nausea and headache interact with each other during attacks of migraine. Symptoms of motion sickness were rated at 2 min intervals during 15 min of optokinetic stimulation in 27 migraine sufferers and 23 age- and sex-matched controls. To document changes in frontotemporal blood flow, pulse amplitude was monitored with photoelectric pulse transducers. To induce facial pain, ice was applied to the temple for 30 s, three times at 4 min intervals during optokinetic stimulation. On another occasion, pain was induced during optokinetic stimulation by immersing the non-dominant hand in 2°C ice water for 30 s, three times at 4 min intervals. On a third occasion, measures were obtained during optokinetic stimulation alone. Migraine sufferers rated themselves as being generally more susceptible to motion sickness than controls. In addition, symptoms of motion sickness provoked by optokinetic stimulation were greater in migraine sufferers than in controls. Painful stimulation of the temple intensified nausea and headache during optokinetic stimulation, whereas painful stimulation of the hand did not. Since nausea also intensifies facial pain during motion sickness, nausea and headache may reinforce each other in a vicious circle. In the absence of painful stimulation, increases in pulse amplitude during optokinetic stimulation were greater in migraine sufferers than controls, possibly because the discomfort associated with motion sickness triggered extracranial vasodilatation in migraine sufferers as part of a fight-or-flight (defense) response. Extracranial vasodilatation did not differ between migraine sufferers and controls when ice was applied to the temple or hand during optokinetic stimulation, implying that the additional discomfort associated with painful stimulation of the head and hand evoked a defense response in controls. These findings suggest that a mechanism which boosts extracranial neurovascular reflexes to stress and which heightens symptoms of motion sickness, increases susceptibility to migraine.
Key Words: migraine; motion sickness; nausea; headache; extracranial vasodilatation
Abbreviations: DNIC= diffuse noxious inhibitory controls; SE = standard error
Received June 4, 2003. Revised October 15, 2003. Accepted October 16, 2003.
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  P. Drummond Tryptophan Depletion Increases Nausea, Headache and Photophobia in Migraine Sufferers Cephalalgia, October 1, 2006; 26(10): 1225 - 1233. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M Volcy, S. Tepper, A. Rapoport, F. Sheftell, and M. Bigal Botulinum Toxin A for the Treatment of Greater Occipital Neuralgia and Trigeminal Neuralgia: A Case Report with Pathophysiological Considerations Cephalalgia, March 1, 2006; 26(3): 336 - 340. [Full Text] [PDF]
|
|
|
|
 |
|
 P. D. Drummond Effect of tryptophan depletion on symptoms of motion sickness in migraineurs Neurology, August 23, 2005; 65(4): 620 - 622. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A Granston and P. Drummond Painful Stimulation of the Temple During Optokinetic Stimulation Triggers Migraine-Like Attacks in Migraine Sufferers Cephalalgia, March 1, 2005; 25(3): 219 - 224. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. Drummond and A Granston Painful Stimulation of the Temple Induces Nausea, Headache and Extracranial Vasodilation in Migraine Sufferers Cephalalgia, January 1, 2005; 25(1): 16 - 22. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 V. K. Gupta Conceptual divide between adaptive and pathogenetic phenomena in migraine: nausea and vomiting Brain, November 1, 2004; 127(11): E18 - E18. [Full Text] [PDF]
|
|
|
|
|
|
P. D. Drummond and A. Granston Reply to: Conceptual divide between adaptive and pathogenetic phenomena in migraine: nausea and vomiting Brain, November 1, 2004; 127(11): E19 - E19. [Full Text] [PDF]
|
|