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Mechanisms of Migraine and Its Treatment

  • Reference work entry
Handbook of Headache

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Abstract

Migraine is characterized by recurrent unilateral headaches, accompanied by nausea, vomiting, photophobia, and/or phonophobia, and in some cases facial symptoms. Current theories suggest that the initiation of a migraine attack involves a primary CNS event, putatively involving mutations in ion channels that render the individuals more sensitive to environmental factors, resulting in a wave of cortical spreading depression when the attack is initiated. Early positron emission tomography (PET) suggested the involvement of a migraine active region in the brainstem. In migraine attacks, data suggest that the pain is associated with the activation of the trigeminal nerve and the release of calcitonin gene-related peptide (CGRP) from the trigeminovascular system. Administration of triptans (5-HT1B/1D receptor agonists) causes the headache to subside and the levels of CGRP to normalize. Administration of CGRP receptor antagonists aborts the headache by specifically blocking the CGRP receptors located within the trigeminovascular system. Modern acute migraine therapy involves modulation of both CGRP and 5-HT1B/1D receptors.

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Acknowledgments

The studies of the authors reviewed here have in part been supported by the Swedish Research Council (project no. 5958).

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Authors and Affiliations

  1. Department of Medicine, Lund University Hospital, Lund, S-221 85, Sweden

    Dr. Lars Edvinsson M.D., Ph.D.

  2. Division of Vascular Medicine and Pharmacology, Department Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands

    Dr. Antoinette Maassen van den Brink

  3. Departamento de Farmacobiología, Cinvestav-Coapa, Tenorios 235, Col. Granjas Coapa, México, DF, 14330, Mexico

    Dr. Carlos M. Villalón

Authors
  1. Dr. Lars Edvinsson M.D., Ph.D.
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  2. Dr. Antoinette Maassen van den Brink
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  3. Dr. Carlos M. Villalón
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Corresponding author

Correspondence to Lars Edvinsson M.D., Ph.D. .

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Editors and Affiliations

  1. Department of Medical and Molecular Sciences, School of Health Sciences, Sapienza University of Rome, Rome, Italy

    Paolo Martelletti

  2. Department of Neuroscience, Norwegian University of Science and Technology, Trondheim, Norway

    Timothy J. Steiner

  3. Department of Neuroscience, Faculty of Medicine, Imperial College London, London, UK

    Timothy J. Steiner

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© 2011 Lifting The Burden

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Edvinsson, L., van den Brink, A.M., Villalón, C.M. (2011). Mechanisms of Migraine and Its Treatment. In: Martelletti, P., Steiner, T.J. (eds) Handbook of Headache. Springer, Milano. https://doi.org/10.1007/978-88-470-1700-9_16

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  • DOI: https://doi.org/10.1007/978-88-470-1700-9_16

  • Publisher Name: Springer, Milano

  • Print ISBN: 978-88-470-1699-6

  • Online ISBN: 978-88-470-1700-9

  • eBook Packages: MedicineReference Module Medicine

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