Piovesan Elcio Juliato, Di Stani Fabrizio, Kowacs Pedro André, Mulinari Rogério Andrade, Radunz Victor Hugo, Utiumi Marco, Muranka Eder B, Giublin Mario Luiz, Werneck Lineu César
Neurology Division, Internal Medicine Department, Hospital de Clínicas, Federal University of Paraná, Rua General Carneiro 181, 80060-900 Curitiba, PR, Brazil.
Arq Neuropsiquiatr. 2007 Sep;65(3A):599-604. doi: 10.1590/s0004-282x2007000400010.
Activation of the trigemino-cervical system constitutes one of the first steps in the genesis of migraine. The objective of this study was to confirm the presence of trigemino-cervical convergence mechanisms and to establish whether such mechanisms may also be of inhibitory origin. We describe a case of a 39-years-old woman suffering from episodic migraine who showed a significant improvement in her frontal headache during migraine attacks if the greater occipital nerve territory was massaged after the appearance of static mechanical allodynia (cortical sensitization). We review trigemino-cervical convergence and diffuse nociceptive inhibitory control (DNIC) mechanisms and suggest that the convergence mechanisms are not only excitatory but also inhibitory.
