Updated Insight into the Pathophysiology of Migraine – 
an Update

Summary

This survey consists of an update of information about the pathophysiology of migraine. All the important aspects are described, including cortical spreading depression and the role of Na+, K+, -ATPase transporter activity, the trigeminal vascular system, vasoactive neuropeptides, especially calcitonin gene-related peptide and pituitary adenylate cyclase-activating polypeptide, vasodilatation and sterile neurogenic inflammation, the significance of sero­tonin and nitric oxide, the transmission of pain along the trigeminal pathway, the significance of the brainstem generator, the role of magnesium and the influence of hormonal factors. The consequences of a knowledge of pathophysiology on the development of specific antimigraine drugs such as the triptans and gepants is mentioned.

Key words:
migraine – pathophysiology – 
cortical spreading depression – 
Na+ – K+ – -ATPase transporters – 
trigeminal vascular system – calcitonin gene-related peptide – serotonin 
receptors – nitric oxide

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