Department of Neurology, Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea.
Headache. 2011 Nov-Dec;51(10):1461-7. doi: 10.1111/j.1526-4610.2011.02010.x. Epub 2011 Nov 2.
Pattern-induced visual discomfort and photophobia are frequently observed symptoms in migraineurs. The presumed pathophysiologic mechanisms of pattern glare and photophobia seem to overlap anatomically within the central nervous system.
To assess the relationship between interictal pattern-induced visual discomfort and ictal photophobia in episodic migraineurs.
We compared pattern-induced visual discomfort among 3 groups: controls, migraineurs without ictal photophobia (MwoP), and migraineurs with ictal photophobia (MwP). Photophobia was assessed with a validated photophobia questionnaire. Visual discomfort tests were performed using 3 striped patterns with different spatial frequencies. After viewing the patterns for 10 seconds, subjects were asked to report the severity of visual discomfort using 4 scales (none, mild, moderate, and severe) and using a 0-10 visual analog scale (VAS). We compared the proportion of subjects choosing moderate-to-severe discomfort and the median values of VAS scores for each pattern among the 3 groups.
We enrolled 35 controls, 18 MwoP, and 44 MwP, and there were no significant differences in clinical features among the 3 groups. MwP reported a significantly higher proportion of moderate-to-severe discomfort and higher median VAS scores than the controls and MwoP did. The intensity of discomfort increased with higher frequency of visual stimuli.
We conclude that MwP experienced more severe pattern-induced visual discomfort as compared with the controls and MwoP.
偏头痛患者常出现视觉诱发不适和畏光等症状。视觉诱发不适和畏光的推测病理生理机制在中枢神经系统中似乎存在解剖学重叠。
评估发作间期偏头痛患者视觉诱发不适与发作期畏光之间的关系。
我们比较了 3 组人群的视觉诱发不适：对照组、无发作期畏光的偏头痛患者（MwoP）和发作期畏光的偏头痛患者（MwP）。采用已验证的畏光问卷评估畏光情况。视觉不适测试使用 3 种不同空间频率的条纹图案进行。在观看图案 10 秒后，患者使用 4 个等级（无、轻度、中度和重度）和 0-10 视觉模拟量表（VAS）报告视觉不适的严重程度。我们比较了 3 组患者中度至重度不适的比例和每种图案的 VAS 评分中位数。
我们纳入了 35 名对照组、18 名 MwoP 和 44 名 MwP，3 组患者的临床特征无显著差异。与对照组和 MwoP 相比，MwP 报告中度至重度不适的比例显著更高，VAS 评分中位数也更高。不适感的强度随视觉刺激频率的增加而增加。
我们得出结论，与对照组和 MwoP 相比，MwP 经历了更严重的视觉诱发不适。
