[Migraine--mechanisms and consequences for treatment].

Abstract

BACKGROUND:

Migraine is a common headache syndrome. The understanding of processes in the brain during a migraine attack has increased significantly during recent years.

MATERIAL AND METHODS:

The article is based on literature retrieved from PubMed, and on own knowledge of older and more recent migraine literature.

RESULTS AND INTERPRETATION:

Patients with migraine probably have increased cortical excitability. Attacks may be initiated by the neurophysiological phenomenon "cortical spreading depression". This may again lead to meningeal inflammation and irritation of pain-sensitive fibres in the trigeminal nerve. There is compelling evidence that an episodic dysfunction of the brain stem plays an important role, either as a primary generator of or a secondary contributor to, migraine attacks. Patients often report allodynia as an expression for central sensitization. Activity in pain-modulating mechanisms is disturbed, and serotonin agonists efficiently stop attacks. The tendency to have repetitive migraine attacks is probably due to a genetic predisposition.

• Authors: Karl Bjørnar Alstadhaug, Rolf Salvesen
• Journal: Tidsskrift for den Norske laegeforening : tidsskrift for praktisk medicin, ny raekke (Tidsskr Nor Laegeforen) Vol. 127 Issue 23 Pg. 3064-8 (Nov 29 2007) ISSN: 0807-7096 [Electronic] Norway
• Vernacular Title: Migrenesmerte--mekanismer og konsekvenser for behandling.
• PMID: 18049496 (Publication Type: English Abstract, Journal Article, Review)

Chemical References

• Serotonin Receptor Agonists

Topics

• Brain Stem (physiopathology)
• Genetic Predisposition to Disease
• Humans
• Migraine Disorders (diagnosis, drug therapy, genetics, physiopathology)
• Migraine with Aura (diagnosis, genetics, physiopathology)
• Nociceptors (physiology)
• Serotonin Receptor Agonists (therapeutic use)