Interictal pattern-induced visual discomfort and ictal photophobia in episodic migraineurs: an association of interictal and ictal photophobia

Headache. 2011 Nov-Dec;51(10):1461-7. doi: 10.1111/j.1526-4610.2011.02010.x. Epub 2011 Nov 2.

Abstract

Background: Pattern-induced visual discomfort and photophobia are frequently observed symptoms in migraineurs. The presumed pathophysiologic mechanisms of pattern glare and photophobia seem to overlap anatomically within the central nervous system.

Objective: To assess the relationship between interictal pattern-induced visual discomfort and ictal photophobia in episodic migraineurs.

Methods: We compared pattern-induced visual discomfort among 3 groups: controls, migraineurs without ictal photophobia (MwoP), and migraineurs with ictal photophobia (MwP). Photophobia was assessed with a validated photophobia questionnaire. Visual discomfort tests were performed using 3 striped patterns with different spatial frequencies. After viewing the patterns for 10 seconds, subjects were asked to report the severity of visual discomfort using 4 scales (none, mild, moderate, and severe) and using a 0-10 visual analog scale (VAS). We compared the proportion of subjects choosing moderate-to-severe discomfort and the median values of VAS scores for each pattern among the 3 groups.

Results: We enrolled 35 controls, 18 MwoP, and 44 MwP, and there were no significant differences in clinical features among the 3 groups. MwP reported a significantly higher proportion of moderate-to-severe discomfort and higher median VAS scores than the controls and MwoP did. The intensity of discomfort increased with higher frequency of visual stimuli.

Conclusions: We conclude that MwP experienced more severe pattern-induced visual discomfort as compared with the controls and MwoP.

Publication types

  • Multicenter Study

MeSH terms

  • Adult
  • Eye Pain / epidemiology
  • Eye Pain / physiopathology*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Migraine Disorders / epidemiology
  • Migraine Disorders / physiopathology*
  • Pain Measurement
  • Pattern Recognition, Visual*
  • Photic Stimulation*
  • Photophobia / epidemiology
  • Photophobia / physiopathology*