218 Headache Medicine, v.2, n.4, p. 218, Oct./Nov./Dec. 2011

Oculo-nasal autonomic symptoms in migraine and cluster

headache (Abstract)

Sinais and sintomas autonônomicos óculo-nasais na migrânea e na cefaleia em

salvas (Resumo)

Maria da Conceição Filgueira Sampaio

Universidade Federal de Pernambuco. Pós-graduação em Neuropsiquiatria e Ciências do Comportamento

(área de concentração: Neurociências). PhD Thesis. 2010.

Orientadores: Marcelo Moraes Valença/Wilson Farias da Silva

Sampaio MCF. Oculo-nasal autonomic symptoms in migraine and cluster headache (Abstract).

Headache Medicine. 2011; 2(4):218

Migraine is a primary, incapacitating headache.

Autonomic symptoms may occur during migraine crises, but

are rarely mentioned in the literature. The aim of this study

was to determine the frequency of autonomic symptoms during

migraine crises. A series of case studies were used, data were

collected from both the private patient records and from the

headache clinic of the Clinical Hospital (HC) of the Federal

University of Pernambuco (UFPE) from July 2005 to July 2008.

Patients who had headaches specifically diagnosed as

migraine, with or without aura, were selected, in accordance

with criteria established by the International Headache Society.

The research was approved by the Ethics Committee of CCS-

UFPE and the results analyzed with SPSS 15.0. Six-hundred-

eight patients were selected, 266 (39.8%) of whom showed

autonomic symptoms as part of clinical signs of migraine crisis.

Of those, 125 had conjunctive hyperemia (102 women and

23 men), 110 had tearing (93 women and 17 men), 70 had

eyelid edema (63 women and 8 men), 21 had runny nose (18

women and 3 men), and 33 had nasal obstruction (25 women

and 8 men). With respect to the laterality of the pain, 309

(46.3%) were unilateral, 160 (24.0%) bilateral and 45 (6.7%)

unibilateral. 87 (13.0%) had unilateral and/or bilateral pain,

8 (1.2%) had unilateral and/or unibilateral, and 1 (0.2%)

had unilateral and/or bilateral and /or unibilateral. Aura were

found in 126 (18.9%) of the 667 examined. The most frequent

triggering factor was stress (emotional), 263 (47.5%) out of

554. 165 (29.8%) were triggered by sleep disturbance, 56

(10.1%) by fasting, 13 (2.3%) by strong smells, 15 (2.7%) by

eating chocolate, 9 (1.6%) by drinking an alcoholic beverage,

1 (0.2%) by physical effort, 9 (1.6%) from eating fried foods,

23 (4.2%) could not specify what the trigger was, and 114

(17.1%) did not supply this information. 405 (60.7%) of the

667 had a family history of migraines. The results of this

research indicate that although autonomic symptoms are

usually found in cases of unilateral pain, they may also be

found in patients with bilateral pain. As to autonomic symptoms

in the case of unilateral pain, eye disturbances (tearing,

conjunctive hyperemia and eyelid edema) were more common

than nasal (runny nose, nasal obstruction). No statistically

Correspondence

Maria da Conceição Filgueira SampaioMaria da Conceição Filgueira Sampaio

Maria da Conceição Filgueira Sampaio

concei2000@uol.com.br

significant relation was found between autonomic symptoms

and unilateral pain, nor was autonomic symptoms related to

the severity of the headaches. Aura, gender, triggering factors

and family history did not show any relationship to the

appearance of autonomic symptoms.

THESIS