Noradrenergic nervous activity in migraine
F. Gotoh, S. Komatsumoto, N. Araki and S. Gomi
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 microgram 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.
