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Origin of pain in migraine: Evidence for peripheral sensitization
The Lancet Neurology, 06/17/09
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
- 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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