MIGRAINE PATHOLOGY:
Migraines involve the release of the peptide neurotransmitter (this peptide is related to the calcitonin gene), from the trigeminal nerve distribution into the intracranial arteries. Vasodilation and extravasation of blood plasma and plasma proteins into the perivascular space is caused by this neurotransmitter. This further causes mechanical stretching and this activates pain nerve endings in the dura. This may be the cause of painful headaches associated with migraines.
TREATMENT:
Anti-inflammatory analgesics such as asprin are often helpful in treating migraine pain.
Beta blockers and calcium channel blockers such as propranolol and verapamil are effective for migraine prophylaxis in some patients.
Anticonvulsants such as valproic acid in the prophylactic treatment of migraines.
Triptans such as sumatriptan are a first-line treatments for migraines, they are partial agonists of serotonin 1B / 1D receptors and selective agonists for 5-HT1D and 5-HT1B and this increases intracranial vasoconstriction, thereby preventing cranial vasodilation, which causes pain by stretching the sensory nerve endings.
Ergot alkaloids such as ergonovine have mixed partial agonistic effects on serotonin-2 receptors and alpha-adrenoceptors; they cause significant smooth muscle contraction, but block alpha-agonistic vasoconstriction.