Migrende Kraniyal Otonomik Belirtiler: İki Olgu Sunumu

Kraniyal otonomik belirtiler göz yaşarması, gözde kızarma, göz kapağı ödemi, myozis, burunda tıkanıklık, burun akıntısı, yüzde ve alında terleme , trigeminal otonomik başağrılarının karakteristik özelliğidir, ancak birçok auralı, aurasız migren hastası da başağrısı atakları sırasında kraniyal otonomik belirtiler gösterebilmektedir. Kraniyal otonomik belirtiler trigemino-otonomik refleksin aktivasyonu ile oluşmaktadır. Kraniyal otonomik belirtilerin görüldüğü migren atakları diğerlerinden farklı olan özelliği sıklıkla daha şiddetli ve tek yanlı olmasıdır. Kraniyal otonomik belirtilerin eşlik ettiği 2 migren vakası sunulmuş ve migrende kraniyal otonomik belirtiler tartışılmıştır

Cranial Autonomic Symptoms In Migraine : Report of Two Cases

Cranial autonomic symptoms CAS conjuctival injection, lacrimation, nasal congestion, rhinorrhea, eyelid edema and forehead/facial sweating are distinguishing features of trigeminal autonomic cephalalgias TAC , but significant number of migrane patients with or without aura may also develop CAS during their attacks of headache. The presence of CAS depends upon the activation of the trigeminal autonomic reflex. Headache that occurs in migraine with cranial autonomic symptoms varried from typical migraine, being more severe and more unilateral. We reported two migraine patients with CAS and discussed CAS in migraine

Keywords:

cranial autonomic symptoms, migraine trigeminal autonomic cephalgias, trigemino-autonomic reflex,

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Headache Classifi cation Subcommitee of the International Headache Society. The International Classifi cation of Headache Disorders. Cephalalgia 2004;24:1-151.

Kraup AO, Mathew NT, Levyman C, Kailasam J, Meadors LA, Villarreal SS. Side-locked migraine and trigeminal autonomic cephalgias: evidence for clinical overlap. Cephalalgia 2003;23:43-9.

Al-Din AS, Mir R, Davey R, Lily O, Ghaus N. Trigeminal cephalgias and facial pain syndromes associated with autonomic dysfunction. Cephalalgia 2005;25:605-11.

Grupta R, Bhatia MS. A report of cranial autonomic symptoms in migraineus. Cephalgia 2007;27:22-8.

Obermann M, Yoon M-S, Dommes P et al. Prevalence of trigeminal autonomic symptoms in migraine: A population-based study. Cephalalgia 2007;27:504-9.

Barbanti P, Fabbrini G, Pesare M, Vanacore N, Cebro R. Unilateral cranial autonomic symptoms in migraine. Cephalalgia 2002;22:256-9.

Lai TH, Fuh JL, Wang SJ. Cranial autonomic symptoms in migraine: Charecteristics and comparasion with cluster headache. J Neurol Neurosurg Psychiatry 2009;80:1116-9.

Torelli P, Cologno D, Manzoni CG. Episodic and chronic cluster headache males: Diff erences in age at onset and habits. In: Olensen J, Goodsby PJ, eds. Cluster Headache and Related Conditions. Oxford:Oxford University Press;1999:42-7.

Faan TD. A history of cigarette smoking is associated with the development of cranial autonomic symptoms with migraine headaches. Headache 2010;50:130-2.

Goodsby PJ, Kaube H. Animal models of headache. In : Olesen J, Tfelt-Hansen P, Welch KMA, eds. The headaches. Philadelphia: Lipincott Williams&Wilkins, 2000:195-201.

Goodsby PJ, Edvinsson L, Ekman R. Vasoactive peptide release in the extracerebral circulation of humans during migraine headache. Ann. Neurol 1990;28:183-7.

May A, Goodsby PJ. The trigemiovascular system in humans: pathophysiological implications for primary headache syndromes of the neural infl uences on the cerebral circulation. J Cereb Blood Flow Metab 1999;19:115-27.

Avnon Y, Nitzan M, Sprecher E, Rogowski Z, Yarnitsky D. Diff erent patterns of parasympatic activation in unilateral and bilateral migraneus. Brain 2003;126:1660-70.

Leone M, D’Amico D, Frediani F, Torri W, Sjaastad O, Bussone G. Clinical considerations on side-locked unilaterality in long-lasting primary headaches. Headache 1993;33:381-4.

Daugaard D, Tfelt P, Thomsen LL; Iversen HK, Olesen J. No eff ect of pure oxygen inhalation on headache induceed by glyceryl trinitrate. J Headache Pain 2010;11:93-5.

Eftedal OS, Lydersen S, Helde G, White L, Brubakk AO, Stovner LJ. A randomized, double blind study of the prophylactic eff ect of hyperbaric oxygen theraphy on migraine. Cephalalgia 2004;24:639-44.

Wilson JR, Foresman BH, Gamber RG, Wright T. Hyperbaric oxygen in treatment of migraine with aura. Headache 1998;38:112-5.