Okulomotorikstörungen als pathophysiologischer Marker von Kopfschmerzerkrankungen

Zusammenfassung

Untersuchungen zu Augenbewegungsstörungen wurden fast ausschließlich zur Migräne durchgeführt. Während initial vor allem vestibulozerebelläre Symptome (vor allem Schwindel) die Untersuchungen veranlassten, rückten in neuerer Zeit Befunde, die Hirnstamm und Zerebellum als in der Pathophysiologie wichtige zentrale Strukturen entdeckten, in das Zentrum des Interesses. Mittels der Elektronystagmographie gelang es, Befunde die auf eine persistierende Affektion von Zerebellum und Hirnstamm hinweisen, elektrophysiologisch zu bestätigen. Im Rahmen wissenschaftlicher Untersuchungen hat die Untersuchung der Augenbewegungsstörung zunächst die wichtigste Bedeutung, während die Datenlage derzeit noch nicht ausreichend ist, sie in der Diagnostik von Kopfschmerzerkrankungen einzusetzen.

Abstract

Investigations regarding ocular motor function have been performed almost exclusively for migraine. Due to frequently seen symptoms like vertigo or dizziness the vestibulocerebellar system was primarily investigated. More recently the focus shifted to the investigation of brain stem and cerebellar structures, which have been shown to play an important role in the pathophysiology of migraine. Using electrooculography it was possible to support findings of a permanent cerebellar and/or brain stem dysfunction. For scientific purposes, electrooculography will be usefull to understand more or the underlying pathologies, the data available, however, do not support its use during the diagnostic process yet.

Headache - migraine - ENG - ocular motor disturbance

Literatur

• 1 Carlsson J, Rosenhall U. Oculomotor disturbances in patients with tension headache.  Acta Otolaryngol. 1988;  106 354-360
• 2 Kobayashi Y, Yagi T, Kamio T. Cervico-vestibular interaction in eye movements.  Auris Nasus Larynx. 1986;  13, Suppl 2 S87-95
• 3 Barlow D, Freedman W. Cervico-ocular reflex in the normal adult.  Acta Otolaryngol. 1980;  89 487-496
• 4 Carlsson J, Rosenhall U. Oculomotor disturbances in patients with tension headache treated with acupuncture or physiotherapy.  Cephalalgia. 1990;  10 123-129
• 5 Schlake H P, Hofferberth B, Grotemeyer K H, Husstedt I W. Electronystagmographic investigations in migraine and cluster headache during the pain-free interval.  Cephalalgia. 1989;  9 271-275
• 6 Olesen J, Goadsby P, Steiner T. The International Classification of Headache Disorders: 2^nd edition.  Lancet Neurol. 2003;  2 720
• 7 Kayan A, Hood J D. Neuro-otological manifestations of migraine.  Brain. 1984;  107 1123-1142
• 8 Harker L A, Rassekh C. Migraine equivalent as a cause of episodic vertigo.  Laryngoscope. 1988;  98 160-164
• 9 Cutrer F M, Baloh R W. Migraine-associated dizziness.  Headache. 1992;  32 300-304
• 10 Savundra P A, Carroll J D, Davies R A, Luxon L M. Migraine-associated vertigo.  Cephalalgia. 1997;  17 505-510
• 11 Whitney S L, Wrisley D M, Brown K E, Furman J M. Physical therapy for migraine-related vestibulopathy and vestibular dysfunction with history of migraine.  Laryngoscope. 2000;  110 1528-1534
• 12 Eviatar L. Vestibular testing in basilar artery migraine.  Ann Neurol. 1981;  9 126-130
• 13 Olsson J E. Neurotologic findings in basilar migraine.  Laryngoscope. 1991;  101 1-41
• 14 Ducros A, Denier C, Joutel A, Cecillon M, Lescoat C, Vahedi K, Darcel F, Vicaut E, Bousser M G, Tournier-Lasserve E. The clinical spectrum of familial hemiplegic migraine associated with mutations in a neuronal calcium channel.  New England Journal of Medicine. 2001;  345 17-24
• 15 Sandor P S, Mascia A, Seidel L, De P V, Schoenen J. Subclinical cerebellar impairment in the common types of migraine: a three-dimensional analysis of reaching movements.  Annals of Neurology. 2001;  49 668-672
• 16 Harno H, Hirvonen T, Kaunisto M A, Aalto H, Levo H, Isotalo E, Kallela M, Kaprio J, Palotie A, Wessman M. et al . Subclinical vestibulocerebellar dysfunction in migraine with and without aura.  Neurology. 2003;  61 1748-1752
• 17 Lisberger S G, Fuchs A F. Role of primate flocculus during rapid behavioral modification of vestibuloocular reflex. Purkinje cell activity during visually guided horizontal smooth-pursuit eye movements and passive head rotation.  J Neurophysiol. 1978;  41 733-763
• 18 Weiller C, May A, Limmroth V, Juptner M, Kaube H, Schayck R V, Coenen H H, Diener H C. Brain stem activation in spontaneous human migraine attacks.  Nat med. 1995;  1 658-660
• 19 Ophoff R A, Terwindt G M, Vergouwe M N, Eijk R van, Oefner P J, Hoffman S M, Lamerdin J E, Mohrenweiser H W, Bulman D E, Ferrari M. et al . Familial hemiplegic migraine and episodic ataxia type-2 are caused by mutations in the Ca2+ channel gene CACNL1A4.  Cell. 1996;  87 543-552
• 20 Zhuchenko O, Bailey J, Bonnen P, Ashizawa T, Stockton D W, Amos C, Dobyns W B, Subramony S H, Zoghbi H Y, Lee C C. Autosomal dominant cerebellar ataxia (SCA6) associated with small polyglutamine expansions in the alpha 1A-voltage-dependent calcium channel.  Nat Genet. 1997;  15 62-69
• 21 May A, Ophoff R A, Terwindt G M, Urban C, Eijk R van, Haan J, Diener H C, Lindhout D, Frants R R, Sandkuijl L A. et al . Familial hemiplegic migraine locus on 19p13 is involved in the common forms of migraine with and without aura.  Hum Genet. 1995;  96 604-608
• 22 Terwindt G M, Ophoff R A, Eijk R van, Vergouwe M N, Haan J, Frants R R, Sandkuijl L A, Ferrari M D. Involvement of the CACNA1A gene containing region on 19p13 in migraine with and without aura.  Neurology. 2001;  56 1028-1032
• 23 Wieser T, Mueller C R, Evers S, Zierz S, Deufel T. Absence of FHM mutations in common forms of migraine.  Clinical Chemistry and Laboratory Medicine. 2003;  41 272-275
• 24 Ishiyama A, Jacobson K M, Baloh R W. Migraine and benign positional vertigo.  Ann Otol Rhinol Laryngol. 2000;  109 377-380