| Ciliospinal reflex response in cluster headache. | |
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MedLine Citation:
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PMID: 8916567 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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The ciliospinal reflex response is mainly mediated by second- and third-order sympathetic nerves to the dilatator muscle of the iris. As the pupillary response to various pharmacological agents indicates a sympathetic dysfunction in patients with cluster headache, the ciliospinal reflex was studied in 25 patients. Five of these patients with cluster headache exhibited a Horner-like syndrome (miosis, ptosis) on the symptomatic side. The pupillary responses to phenylephrine and tyramine showed that the Horner-like syndrome was due to postganglionic sympathetic nerve dysfunction. Their ciliospinal reflex response on the symptomatic side was significantly less than in controls and in other patients with cluster headache, lacking a Horner-like syndrome. This also applied to the nonsymptomatic side compared to the majority of cluster headache patients without any clinical evidence of sympathetic nerve dysfunction. These findings seem to delineate those patients with a Horner-like syndrome as a subgroup, distinctly separated from the majority of cluster headache patients. Furthermore, the findings indicate that the Horner-like syndrome is not a consequence of repeated attacks of headache over many years, but is a manifestation of bilateral cephalic sympathetic dysfunction being more marked on the symptomatic side. In 18 (72%) of our 25 patients, an asymmetric and lower ciliospinal reflex response on the symptomatic side was seen. In 3 (12%) patients, there was no difference in the response. In 4 patients (16%), the incorrect side was indicated by an asymmetric reflex response. Two of these patients (8%) had suffered from cluster headache on alternating sides. In summary, the findings support the concept that dysfunction of the sympathetic nervous system, whether peripheral or central is involved in the pathophysiology of cluster headache. |
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Authors:
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U Havelius; M Heuck; P Milos; B Hindfelt |
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Publication Detail:
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Type: Comparative Study; Journal Article |
Journal Detail:
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Title: Headache Volume: 36 ISSN: 0017-8748 ISO Abbreviation: Headache Publication Date: 1996 Oct |
Date Detail:
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Created Date: 1997-02-06 Completed Date: 1997-02-06 Revised Date: 2009-02-02 |
Medline Journal Info:
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Nlm Unique ID: 2985091R Medline TA: Headache Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 568-73 Citation Subset: IM |
Affiliation:
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Department of Neurology, University Hospital MAS, Lund University, Malmö, Sweden. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Cluster Headache / physiopathology* Female Horner Syndrome / physiopathology Humans Male Middle Aged Nociceptors / physiology Reflex* Reflex, Pupillary* Sympathetic Nervous System / physiopathology* |
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