Migraines, You Get On My Nerves

As discussed in my previous blog, migraines are a complicated neurovascular process. We know that migraines accounts for many neurological symptoms. We have talked about the role blood vessels and the vasculature of migraines but there is also an important role of the nervous systems outside the brain. This is called the peripheral nervous systems. The peripheral nerves can also play an important role in pathophysiological role in migraines.

There is a complicated interrelationship between the brain and the peripheral nervous system in migraines. We know there are important brain centers in the brain that are activated during the migraine process. Those centers can also receive information outside of the brain and the same pain centers of the brain can also cause those nerves to be overactive. There is another part of the peripheral nervous system called the autonomic nervous system that is also active in migraines. The autonomic nervous system controls involuntary parts of the nervous system. This can be seen when patients have symtpoms such as tearing and redness of eyes, nasal congestion, and running nose due to alterations of the autonomic nervous system during a migraine.

Many patients can have abnormal sensory symptoms during the migraines. One common system called allodynia. When the patient has allodynia, normal touch can feel very painful even when brushing one's hair. This is an example of how the peripheral nerves can play an important role in the symptoms of a migraine. Many treatments for migraines address the peripheral nervous system. I do various nerve blocks to temporarily block certain nerves that play a role in migraines, such as an occipital nerve block. An occipital nerve block is a common nerve block in which the occipital nerves are temporarily numbed with local anesthetics such as lidocaine and bupivacaine. There are also multiple neuromodulating devices that will stimulate certain nerves that play a role in migraines. There are surgical procedures that can be done as well. So, if you have a migraine and feel like everything is getting on your nerves. Now you understand more why that happens. If you want to keep learning more about migraines, tune in every day to my blog.  

Dr. Sharisse Stephenson Dr. Stephenson is a Neurologist and a Board Certified Headache Specialist and Brain Injury Medicine Specialist. She has postgraduate training in neurological disorders and stroke management from Tufts University in Boston.

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