Migraine--disease or syndrome?

Area of Science:

• Neurology
• Neuroscience
• Vascular Biology

Background:

• Migraine is often considered a distinct disease entity due to its typical symptoms.
• However, atypical presentations and conditions mimicking migraine symptoms challenge this classification, suggesting it might be a syndrome.
• Existing classifications fail to fully encompass the complex nature of migraine.

Purpose of the Study:

• To propose a new conceptual model for migraine.
• To explain the underlying mechanisms of migraine symptoms.
• To differentiate migraine from conditions with similar presentations.

Main Methods:

• Conceptual review of existing literature on migraine pathophysiology.
• Delineation of the trigeminovascular system's role.
• Integration of neurovascular and systemic disease interactions.

Main Results:

• Migraine is proposed as a constitutional predisposition of the neurovascular system.
• Excessive reactivity to stimuli leads to hyperactivity of the brain and trigeminovascular apparatus.
• Activation of this system causes vascular headaches and associated neurological symptoms like prodrome and aura.

Conclusions:

• Migraine is best understood as a neurovascular reactivity pattern, not solely a disease or syndrome.
• This model accommodates both typical migraine and mimic presentations.
• It highlights the trigeminovascular system's central role in migraine pathophysiology.