Massaging over the greater occipital nerve reduces the intensity of migraine attacks: evidence for inhibitory trigemino-cervical convergence mechanisms

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 cas...

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Bibliographic Details
Published in:Arquivos de neuro-psiquiatria 2007-09, Vol.65 (3A), p.599-604
Main Authors: 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
Format: Article
Language:eng ; por
Subjects:
Adult
Cervical Vertebrae - physiopathology
Electric Stimulation Therapy
Female
Humans
Massage
Migraine without Aura - physiopathology
Migraine without Aura - therapy
Nerve Block - methods
NEUROSCIENCES
Nociceptors - physiology
Occipital Lobe - physiology
Pain Measurement
PSYCHIATRY
Severity of Illness Index
Time Factors
Trigeminal Nucleus, Spinal - physiopathology
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Summary: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.
ISSN:0004-282X
1678-4227
1678-4227
0004-282X
DOI:10.1590/S0004-282X2007000400010