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5.33 – Migraine – A Disorder Involving Trigeminal Brainstem Mechanisms
Published 2008 · Medicine
Migraine is a common, disabling disorder one of whose core manifestations is activation, or the perception of activation, of nociceptive trigeminal neurons. Neurons in the most caudal medulla and dorsal horns of the two upper cervical cord segments receive input from trigeminally innervated structures and from nociceptive afferents in the distribution of C2, the trigeminocervical complex (TCC). TCC neurons project to thalamus and are influenced by neurotransmitters that have been shown to be involved in migraine, and by brainstem modulatory structures implicated in migraine by brain functional imaging studies. Studying the physiology and pharmacology of these systems will enhance understanding of migraine and related primary headache disorders.