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Fumio Gotoh, MD; Satoru Komatsumoto, MD; Nobuo Araki, MD; Shintaro Gomi, MD

Arch Neurol. 1984;41(9):951-955.

Abstract
• The autonomic nervous function in patients with migraine was studied during headache-free intervals. The following observations were made: (1) a decrease in overshoot in Valsalva's maneuver; (2) orthostatic hypotension; (3) low levels of plasma norepinephrine in the steady state; (4) failure in elevation of the plasma norepinephrine level after head-up tilting; (5) dilatation of the pupils after instillation in the eye of 1.25% epinephrine; and (6) a long recovery time in tests by bolus injection of 0.1 µg of norepinephrine bitartrate per kilogram. The above findings suggest that patients with migraine show sympathetic hypofunction together with denervation hypersensitivity of the iris and the arteries, and that a defective noradrenergic nervous system may play a role in the pathogenesis of migraine.

Author Affiliations
From the Department of Neurology, School of Medicine, Keio University, Tokyo.

Footnotes
Accepted for publication Dec 13, 1983.

Reprint requests to Department of Neurology, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo 160, Japan (Dr Gotoh).

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