Migraine Pathology:

Migraines that are involved in the release of peptide neurotransmitters, a peptide that is associated with CGRP (from the nerve through the cerebral arteries). Therefore, this neurotransmitter induces vasodilation and extravasation of blood plasma and plasma protein into the perivascular oedema, as a result causing mechanical stretching in the dura and the pain nerve endings are activated.

Treatments:

1. Triptans - It is a first line drug therapy for migraines. It is selective agonists for 5-HT 1D and - 1B receptors. These drugs activate the 5-HT 1D and - 1B receptors on the presynaptic trigeminal nerve endings preventing the release of the peptide neurotransmitters. E.g. Sumatriptan.

2. Ergot alkaloids - They have mixed partial agonistic effects on the 5-HT2 receptors and the alpha adrenergic receptors. They cause contraction of the smooth muscle but also blacks alpha agonist vasoconstriction which helps to reduce the vasodilation which causes migraines. E.g. Ergonovine.

3. Anti-inflammatory analgesics - These drugs are used to control the pain caused by migraines. E.g. Aspirin.

4. Anticonvulsants - it suppress excessive activation of the nerve ends and it is used as a prophylactic treatment. E.g. Valproic.

5. Beta- and calcium channel blockers - are also used in the prophylactic treatment of migraines. E.g. Propranolol and Flunarizine.