[Migraine--mechanisms and consequences for treatment].
BACKGROUND
Migraine is a common headache syndrome. The understanding of processes in the brain during a migraine attack has increased significantly during recent years.


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


CONCLUSIONS
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.
Alstadhaug
Karl Bjørnar
KB
Nevrologisk avdeling, Nordlandssykehuset, 8092 Bodø. karl.bjornar.alstadhaug@nordlandssykehuset.no
Salvesen
Rolf
R
D001933:Brain Stem / Q000503:physiopathology; D020022:Genetic Predisposition to Disease; D006801:Humans; D008881:Migraine Disorders / Q000175:diagnosis / Q000188:drug therapy / Q000235:genetics / Q000503:physiopathology; D020325:Migraine with Aura / Q000175:diagnosis / Q000235:genetics / Q000503:physiopathology; D009619:Nociceptors / Q000502:physiology; D017366:Serotonin Receptor Agonists / Q000627:therapeutic use
D017366:Serotonin Receptor Agonists