The pathogenesis of migraine

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The older ideas that contracted skeletal muscles and dilated arteries are primary causes of head pain are no longer tenable; although such mechanisms may, at times, serve as important pain causes, they are usually epiphenomenal (Raskin, In Headache, Second edition, Churchill Livingstone, 1988, pp 99–133). It has been suggested that disturbance of serotonergic neurotransmission in brain may account for the headache that attends cerebral ischemia and arteriovenous malformations as well as migraine [l]. This review will focus on clinical, pharmacologic and biochemical lines of evidence that support this view.

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