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Managing migraine associated with sensitization.

Rami Burstein1, Moshe Jakubowski

  • 1Departments of Anesthesia and Program in Neuroscience, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA. rburstei@bidmc.harvard.edu

Handbook of Clinical Neurology
|September 7, 2010
PubMed
Summary
This summary is machine-generated.

Migraine pain and allodynia stem from trigeminovascular neurons. Triptans are effective for migraine if taken early, while NSAIDs can help when allodynia is established.

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Area of Science:

  • Neuroscience
  • Pain Research
  • Pharmacology

Background:

  • Migraineurs often experience throbbing pain and cutaneous allodynia.
  • These symptoms involve peripheral and central trigeminovascular neurons.
  • Peripheral sensitization causes initial throbbing pain; central sensitization causes allodynia.

Purpose of the Study:

  • To investigate the mechanisms of migraine pain and allodynia.
  • To determine the efficacy of triptans and NSAIDs in migraine treatment.

Main Methods:

  • The study focuses on the neurobiological underpinnings of migraine symptoms.
  • It examines the role of trigeminovascular neuron sensitization.
  • The therapeutic effects of triptans and NSAIDs are analyzed.

Main Results:

  • Peripheral trigeminovascular neuron sensitization mediates initial migraine pain.
  • Central trigeminovascular neuron sensitization leads to cutaneous allodynia.
  • Triptans inhibit peripheral-to-central trigeminovascular neuron signaling.
  • Triptans are effective if administered before or soon after allodynia onset.
  • Intravenous NSAIDs can alleviate pain in patients who missed the triptan window.

Conclusions:

  • Early triptan intervention is crucial for managing migraine with allodynia.
  • NSAIDs offer an alternative treatment for established allodynia.
  • Understanding neuronal sensitization is key to effective migraine management.