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  Contents > Previous page > Article detail print Order
o Issue N# 1 - 2004 o

OTONEUROLOGY

Migraine, neurone and vessel


Authors : M. Ballester (Dijon)

Ref. : Rev Laryngol Otol Rhinol. 2004;125,1:71-72.

Article published in french
Downloadable PDF document french



Summary : What, of the neurone or the vessel, triggers a migraine? Neuronal theory seems to dominate. Functional imaging confirms a neuronal primum movens. It shows that the classical hypothesis a migraine is linked to the reduction of the regional cerebral blood flow (rCBF), followed by a vasodilatation responsible for the headache , is false. On the contrary, an increase of the rCBF is very often observed at the phase of the aura. One of the possible pathophysiological mechanisms would be the activation of the trigemino-vascular system, with neurogen inflammation of meningeal vessels and central sensitization of trigeminal neurones. The primum movens could be a propagated cortical depression, already observed in patients having presented crises while they were in a positron emission tomography scan (PET-Scan). The links with the cerebral trunk structures remains to clarify. The anti-epileptics acting on the cerebral cortex but also on the cerebral trunk, as well as the anti-5-HT2 on the trigemino-vascular system, are effective therapeutics. The mechanisms of action of calcic inhibitors and beta blockers remains unclear.

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