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  • Title: [Migraine--mechanisms and consequences for treatment].
    Author: Alstadhaug KB, Salvesen R.
    Journal: Tidsskr Nor Laegeforen; 2007 Nov 29; 127(23):3064-8. PubMed ID: 18049496.
    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.
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