Slow cortical potentials in migraine. Predictive value and possible novel therapeutic strategies to prevent an attack

During the pain-free interval migraine patients display increased negative amplitudes in recordings of slow cortical potentials compared to healthy controls. This fact can be linked to diminished or absent habituation during the recording session. This difference in amplitude and habituation is at its maximum the day before the migraine attack. After the attack, amplitudes and habituation course are comparable with those of healthy controls. This observation enables the migraine patient to predict the next migraine attack and to become acquainted with other symptoms which indicate an imminent attack and which can be present one or two days before it. During this period, when the attack has begun but the pain has not yet developed, novel therapeutic strategies for preventing the full-blown attack can be introduced. These "pre-emptive" strategies--which may include intake of tranquillizers to reduce the high cortical arousal, but also non-medical relaxation methods--constitute neither acute treatment (because there is no acute pain) nor prophylaxis.