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Migraine: diagnosis and treatment
Published in Stephen D. Silberstein, Richard B. Upton, Peter J. Goadsby, Headache in Clinical Practice, 2018
Stephen D. Silberstein, Richard B. Upton, Peter J. Goadsby
In the draft revision of the IHS criteria (Table 6.2), migraine with aura is subdivided into typical aura with migraine headache (1.2.1), typical aura with nonmigraine headache (1.2.2), typical aura without headache (1.2.3), migraine with prolonged aura (1.2.4), familial hemiplegic migraine (FHM) (1.2.5), sporadic hemiplegic migraine (1.2.6), basilar-type migraine (1.2.7), and migraine with acute onset aura (1.2.8).
A critical review of the neurovascular nature of migraine and the main mechanisms of action of prophylactic antimigraine medications
Published in Expert Review of Neurotherapeutics, 2021
Bruno A. Marichal-Cancino, Abimael González-Hernández, Raquel Guerrero-Alba, Roberto Medina-Santillán, Carlos M. Villalón
Interestingly, the efficacy of non-contractile antimigraine agents [49] has been used as an argument to propose migraine as an entirely neurogenic pathology [50]. Nevertheless, those agents lacking contractile actions in mammal arteries (e.g. lasmiditan) still prevent trigeminal CGRP release [51] and, hence, both its direct vascular (i.e. vasodilatation) and neural (i.e. pain transmission) actions. On the other hand, not every section of the intracranial blood vessels seems to be phenomenologically associated with migraine, and some studies have omitted this peculiarity, as examined recently by Prof. Shevel [52]. In support of the above notion, cautery ablation of selected terminal branches of the external carotid artery was reported to suppress sporadic hemiplegic migraine in three patients [53], suggesting a critical vascular role of these terminal branches in these specific cases. In fact, an interesting method for detecting when migraines have a cranial vascular origin of pain has been recently proposed by Prof. Shevel [54], suggesting that cranial blood vessels are also essential elements in the pathophysiology of migraine.