Sympathetic skin response from neck area in patients with unilateral migraine

Bektaş Korkmaz, Sympathetic Skin Responses from Neck Area in Patients with Unilateral Migraine, Medical Specialty Thesis, Bolu, 2008.Since the first description of migraine by Aretaeus who had lived in Capadocis at 2nd century A.C., etiology of migraine has not been clarified yet, in spite of many studies about it and many theories suggested so far.One of the main concerns about uncertainty of its etiology, although many information was obtained about its clinical features and treatment, is multiple interactions in the central nervous system due to the nature of migraine, and there is confusion about whether it is a result or a reason.The presence of autonomic dysfunction during migraine pain or during painless period has been shown using different methods in studies which were previously performed. In this current investigation, in patients with unilateral migraine headache and in normal controls, it was aimed to assess the sympathetic function during attack, post attack and interval periods and to compare these findings, by recording sympathetic skin responses from neck area which was not studied before.Total of 37 unilateral migraine patients (30 female, 7 male) who were fulfilling the criteria of International Headache Society (2004) were recruited from our outpatient clinic between the years 2006-2007. The control group consisted of 21 healthy individuals (16 female, 5 male) who are employees or students of our Medical Faculty.Mean latency and maximum amplitude values of sympathetic skin responses obtained from neck areas of the patients during attack, post attack and interval periods were calculated. We compared the mean latency and the maximum amplitude values of the symptomatic side with the data of asymptomatic side, and with the data of the control group. We also comparedviiithe responses of the patients with right sided headache with the responses of the patients with left sided headache. All statistical analyses were performed using SPSS.As a conclusion, on the neck area, we observed hypoactivity in the attack and interval periods, and a relative hyperactivity in the post attack period bilaterally regardless of the symptomatic side. These findings suggest that there are ongoing bilateral sympathetic hypoactivity on the neck area and there occurs a temporary increase in the function of sympathetic sudomotor activity in the recovery period of headache.Key words: Primary headache, Migraine, Autonomic dysfunction, Sympathetic skin response, Neck