Skip to main content
SpringerLink
Log in

Mechanism and management of migraine

  • Original Article
  • Published:
Comprehensive Therapy

The successful treatment of migraine is difficult but worth the effort. It taps every resource of the physician. Probably more hours of suffering are caused by migraine than by any other human affliction. Knowledge of its secrets is incomplete but increasing. For these reasons it presents a unique challenge. John R. Graham, MD, MACP Treatment of Migraine, 1955

Abstract

Migraine is a condition that affects 10%–15% of the population. Abortive treatment is always indicated because the intense headaches interfere with normal functioning. Preventive treatment is indicated when the headaches exceed 3–4 per month.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Goldstein M, Chen TC. The epidemiology of disabling headache. Adv Neurol. 1982;33:377–390.

    PubMed  CAS  Google Scholar 

  2. Graham JR, Wolff HG. Mechanism of migraine headache and action of ergotamine tartrate. Arch Neurol Psychiat. 1938;39:737–763.

    CAS  Google Scholar 

  3. Schumacher GA, Wolff HG. Experimental studies on headache. A. Contrast of histamine headache with the headache of migraine and that associated with hypertension. B. Contrast of vascular mechanisms in preheadache and in headache phenomena of migraine. Arch Neurol Psychiat. 1941;45:199–214.

    Google Scholar 

  4. Tunis MM, Wolff HG. Long-term observations of the reactivity of the cranial arteries in subjects with vascular headache of the migraine type. Arch Neurol Psychiat. 1953; 70:551–557.

    CAS  Google Scholar 

  5. Iversen HK, Nielsen TH, Olesen J, Tfelt-Hansen P. Arterial responses during migraine headache. Lancet. 1990;336: 837–839.

    Article  PubMed  CAS  Google Scholar 

  6. De Hoon JNJM. Migraine and Anti-Migraine Drugs. Focus on Cardiovascular Aspects [thesis]. University Maastricht, The Netherlands, 2000.

    Google Scholar 

  7. Chapman LF, Ramos AO, Goodell H, et al. A humoral agent implicated in vascular headache of the migraine type. Arch Neurol. 1960;3:223–229.

    PubMed  CAS  Google Scholar 

  8. Goadsby PJ, Edvinsson L, Ekman R. Vasoactive peptide release in the extracerebral circulation of human during migraine headache. Ann Neurol. 1990;28:183–187.

    Article  PubMed  CAS  Google Scholar 

  9. Wolff HG, Tunis MM, Goodell H. Studies on headache. Evidence of tissue damage and changes in pain sensitivity in subjects with vascular headaches of the migraine type. Arch Int Med. 1953;92:478–484.

    CAS  Google Scholar 

  10. Burnstein R, Yarnitsky D, Goor-Aryeh I, et al. An association between migraine and cutaneous allodynia. Ann Neurol. 2000;47:614–624.

    Article  Google Scholar 

  11. Anselmi B, Baldi E, Casacci F, Salmon S. Endogenous opioids in cerebrospinal fluid and blood in idiopathic headache sufferers. Headache. 1980;20:294–299.

    Article  PubMed  CAS  Google Scholar 

  12. Marcussen RM, Wolff HG. Studies on headache. 1. Effects of carbon dioxide-oxygen mixtures given during preheadache phase of the migraine attack. 2. Further analysis of the pain mechanisms in headache. Arch Neurol Psychiat. 1950;63:42–51.

    CAS  PubMed  Google Scholar 

  13. Hare EH. Personal observations on the spectral march of migraine. J Neurol Sci. 1966;3:259–264.

    Article  PubMed  CAS  Google Scholar 

  14. Milner PM. Note on a possible correspondence between the scotomas of migraine and spreading depression of Leão. Electroencephalogr Clin Neurophysiol. 1958;10:705.

    Article  CAS  PubMed  Google Scholar 

  15. Olesen J, Friberg L, Olsen TS, et al. Timing and topography of cerebral blood flow, aura, and headache during migraine attacks. Ann Neurol. 1990;28:791–798.

    Article  PubMed  CAS  Google Scholar 

  16. Olesen J, Larsen B, Lauritzen M. Focal hyperemia followed by spreading oligemia and impaired activation of rCBF in classic migraine. Ann Neurol. 1981;9:344–352.

    Article  PubMed  CAS  Google Scholar 

  17. Sanchez del Rio M, Bakker D, Wu O, et al. Perfusion weighted imaging during migraine: spontaneous visual aura and headache. Cephalalgia. 1999;19:701–707.

    Article  PubMed  CAS  Google Scholar 

  18. Welch KMA, Levine SR, D'Andrea G, et al. Preliminary observations on brain energy metabolism in migraine studied by in vivo phosphorus 31 NMR spectroscopy. Neurology. 1989;39:538–541.

    PubMed  CAS  Google Scholar 

  19. Spierings ELH. Angiographic changes suggestive of vasospasm in migraine complicated by stroke. Headache. 1990;30:727–728.

    Article  PubMed  CAS  Google Scholar 

  20. Spierings ELH. Recent advances in the understanding of migraine. Headache. 1988;28:655–658.

    Article  PubMed  CAS  Google Scholar 

  21. Palmer JE, Chronicle EP, Rolan P, Mulleners WM. Cortical hyperexcitability is cortical under-inhibition: evidence from a novel functional test of migraine patients. Cephalalgia. 2000;20:525–532.

    Article  PubMed  CAS  Google Scholar 

  22. Ophoff RA, Terwindt GM, Vergouwe MN, et al. Familial hemiplegic migraine and episodic ataxia type-2 are caused by mutations in the Ca2+ channel gene CACNL1A4. Cell. 1996;87:543–552.

    Article  PubMed  CAS  Google Scholar 

  23. Weiller C, May A, Limmroth V, et al. Brain stem activation in spontaneous human migraine attacks. Nature Med. 1995;1:658–660.

    Article  PubMed  CAS  Google Scholar 

  24. Spierings ELH, Keywood C. Clinical factors associated with low headache recurrence with frovatriptan [Abstract]. Cephalalgia. 2000;20:340.

    Google Scholar 

  25. Sheftell FD, O'Quinn S, Watson C, et al. Low migraine recurrence with naratriptan: clinical parameters related to recurrence. Headache. 2000;40:103–110.

    Article  PubMed  CAS  Google Scholar 

  26. Kaufman J, Levine I. Acute gastric dilatation of the stomach during attack of migraine. Radiology. 1936;27:301–302.

    Google Scholar 

  27. Boyle R, Behan PO, Sutton JA. A correlation between severity of migraine and delayed gastric emptying measured by an epigastric impedance method. Br J Clin Pharmacol. 1990; 30:405–409.

    PubMed  CAS  Google Scholar 

  28. Salonen R, Petricoul O, Sabin A, et al. Encapsulation delays absorption of sumatriptan tablets [Abstract]. Cephalalgia. 2000;20:423–424.

    Article  Google Scholar 

  29. Volans GN. The effect of metoclopramide on the absorption of effervescent aspirin in migraine. Br J Clin Pharmacol. 1975;2:57–63.

    PubMed  CAS  Google Scholar 

  30. Laska EM, Sunshine A, Mueller F, et al. Caffeine as an analgesic adjuvant. JAMA. 1984;251:1711–1718.

    Article  PubMed  CAS  Google Scholar 

  31. Graham JR. Rectal use of ergotamine tartrate and caffeine alkaloid for the relief of migraine. N Engl J Med. 1954;250:936–938.

    Article  PubMed  CAS  Google Scholar 

  32. Spierings ELH. The (suma)triptan history revisited [Letter]. Headache. 2000;40:766–767.

    Article  PubMed  CAS  Google Scholar 

  33. Spierings ELH, Saxena PR. Effect of ergotamine on cranial arteriovenous shunting in experiments with constant flow perfusion. Eur J Pharmacol. 1979;56:31–37.

    Article  PubMed  CAS  Google Scholar 

  34. Heyck H. Pathogenesis of migraine. Res Clin Stud Headache. 1969;2:1–28.

    Google Scholar 

  35. Goadsby PJ, Edvinsson L. Sumatriptan reverses the changes in calcitonin gene-related peptide seen in the headache phase of migraine. Cephalalgia. 1991;11(Suppl 11):3–4.

    Google Scholar 

  36. Spierings ELH. Optimum-dose determination of the triptans [Abstract]. Headache. 2000;40:433–434.

    Google Scholar 

  37. Spierings ELH. Eletriptan in acute migraine: a double-blind, placebo-controlled comparison to sumatriptan [Letter]. Neurology. 2000;55:735–736.

    PubMed  CAS  Google Scholar 

  38. Tfelt-Hansen P, Paalzow L. Intramuscular ergotamine: plasma levels and dynamic activity. Clin Pharmacol Ther. 1985; 37:29–35.

    Article  PubMed  CAS  Google Scholar 

  39. Tfelt-Hansen P, Aebelholt Krabbe A. Ergotamine abuse. Do patients benefit from withdrawal? Cephalalgia. 1981;1:29–32.

    Article  PubMed  CAS  Google Scholar 

  40. Spierings ELH. Management of Migraine. Boston, Massachusetts: Butterworth-Heinemann; 1996.

    Google Scholar 

  41. Graham JR, Suby HI, LeCompte PM, Sadowsky NL. Inflammatory fibrosis associated with methysergide therapy. Res Clin Stud Headache. 1967;1:123–164.

    Google Scholar 

  42. Miranda HF, Bustamante D, Kramer V, et al. Antinociceptive effects of Ca2+ channel blockers. Eur J Pharmacol. 1992; 217:137–141.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Neurology, Brigham and Women's Hospital Harvard Medical School, Boston, Mass

    Egilius L. H. Spierings MD, PhD (Associate Clinical Professor)

Authors
  1. Egilius L. H. Spierings MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

Additional information

The author has stated that he does not have a significant financial interest or other relationship with any product manufacturer or provider of services discussed in this article.

About this article

Cite this article

Spierings, E.L.H. Mechanism and management of migraine. Compr Ther 28, 241–254 (2002). https://doi.org/10.1007/s12019-002-0034-8

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12019-002-0034-8

Keywords

Search

Navigation