We know that migraines are a complicated neurovascular process. Multiple systems in the body play a role in migraines. We have talked about the role of blood vessels, peripheral nerves, and centers of the brain in migraines. In addition, there is also an important role of inflammation in migraines. Neurogenic inflammation is a pathophysiological process in which there is an increase release of important inflammatory chemicals.
Neurogenic inflammation is initiated by the activation of nerves of the peripheral nervous system. When these nerves are activated, there can be a release of certain neuropeptide or proteins that play a role in inflammation. In migraines, we believe that activated of sensory trigeminal nerves plays an important role in the release of these inflammatory proteins. Many factors can contribute to the activation of this process such triggers can include stress, levels of estrogen, and certain chemicals. Treatments aimed at helping migraines have been developed to act on this process. Calcitonin gene related peptide also known as CGRP is a peptide released from the brain. Furthermore, we now have multiple medications in the market that act on this protein. Many patients have found that taking non steroid anti-inflammatory drugs, such as naproxen and ibuprofen can help their migraines. However, I still recommend not taking any over the counter medications without the discretion of your physician. The overuse of over-the-counter drugs has risks and can often lead to multiple adverse events. Steroids are also often given for acute migraine treatment. If you feel like your head is completely inflamed during a migraine, now you understand. Continue to tune in every week on this blog, as we start to learn more about treatments and ways to try to improve migraines by acting on all these systems.