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Origin of pain in migraine: Evidence for peripheral sensitization
The Lancet Neurology, 06/29/09

Olesen J et al. – An editorial review of evidence for peripheral sensitization in the origin of migraine pain focuses on activation of peripheral nociceptors. Migraine may be explained to pts as a brain disorder with headache originating in sensory fibers that convey pain signals from intracranial and extracranial blood vessels.

Methods

Summary of evidence and viewpoint on peripheral sensitization in migraine pain origin

Results

Despite evidence for the role of central sensitization in migraine pathophysiology, neuronal hyperexcitability may depend on activation of peripheral nociceptors
Although migraine onset may occur deep-brain structures, some evidence indicates that the headache phase depends on nociceptive input from perivascular sensory nerve terminals
Evidence for input from extracranial, dural, and pial arteries as well as evidence against these locations
Afferents are probably excited in all 3 territories or importance of individual territories varies among pts

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