De Marinis M, Assenza S, Carletto F
Department of Neurological Sciences, La Sapienza University, Rome, Italy.
Cephalalgia. 1998 Mar;18(2):77-84. doi: 10.1046/j.1468-2982.1998.1802077.x.
Oculosympathetic function was studied in 20 headache-free migraine patients and in 20 controls. Pupillary investigation was performed under basal conditions, and after instillation of tyramine (2%) and phenylephrine (1%) eyedrops. Each test was performed twice shortly after a spontaneous 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 shortly after the attack. These abnormal responses were bilateral in all patients and slightly anisocoric in some. They were significantly (p<0.001) more pronounced in the patients who had pain and pronounced vascular features. The reduced oculosympathetic response to tyramine, as well as the hypersensitivity to phenylephrine, was less evident 7 days after the attack and absent after 15 days. A transient and bilateral post-ganglionic oculosympathetic hypofunction, with adrenoceptor hypersensitivity, was found to be temporally related to the migraine attack, regardless of the side or predominant side of pain.
对20名无头痛的偏头痛患者和20名对照者的眼交感神经功能进行了研究。在基础条件下以及滴入酪胺（2%）和去氧肾上腺素（1%）眼药水后进行瞳孔检查。每次测试在自发发作后不久进行两次，然后在7天和15天后重复。在患者中，酪胺诱导的正常散瞳反应显著降低（p<0.001），而去氧肾上腺素滴入在发作后不久进行的两次评估中均引起显著的瞳孔扩张（p<0.01）。所有患者的这些异常反应均为双侧性，部分患者有轻微的瞳孔不等大。在有疼痛和明显血管特征的患者中，这些反应更为显著（p<0.001）。对酪胺的眼交感神经反应降低以及对去氧肾上腺素的超敏反应在发作后7天不太明显，15天后消失。发现一种短暂的双侧节后眼交感神经功能减退，伴有肾上腺素能受体超敏反应，在时间上与偏头痛发作相关，与疼痛的一侧或主要一侧无关。
