Abstract

Background: Autonomic disturbances are common in the patients of migraine, predominantly sympathetic hypofunction was observed while parasympathetic system also showed abnormal behavioral response. There is no comprehensive study regarding these aspects in migraineurs in India. Aims &
Objective: To study the state of autonomic nervous system in the patients of episodic migraine during interictal period.
Materials and Methods: This case control study done employing a sample of 54 migraine cases selected from the outpatient department, GB Pant hospital Delhi. Selection of patients was based on the clinical diagnosis by neurologists and each case fulfilling the International headache society criteria 2004 irrespective of aura status. The control pool was formed by 30 normal healthy participants from Maulana Azad Medical College. All participants were aged between 20 to 40 years. Informed consent was taken from all the participants and the ethical clearance was obtained from the college. Sympathetic function tests: handgrip test, cold pressor Test, sympathetic skin response and parasympathetic function tests: resting heart rate, standing to lying Ratio, 30: 15 ratio, Valsalva Ratio and tachycardia Ratio. Assessment of the autonomic system was carried out during headache free interval.
Results: Of the sympathetic tests, the sympathetic skin response showed a significant statistical difference between cases and controls while remaining parameters showed no statistical significance. Of the parasympathetic tests, none of them revealed any statistical significance between cases and controls. Conclusion: In contrast to many western studies which showed sympathetic hypofunction, we observed sympathetic hyperfunction during the interictal period, while parasympathetic system was normal.