Observations on 500 cases of migraine and allied vascular headache

The development of allodynia suggests the withdrawal of inhibition of the afferent inflow from cutaneous receptors in line with that from cranial arteries causing the pulsatile nature of the headache, and from the special senses responsible for enhanced susceptibility to light, sound and smells. Following the serotonin trail our team reported that a double blind trial of the serotonin uptake inhibitor amitriptyline proved effective in the relief of chronic daily headache 8 and presented a pilot study of the monoamine inhibitor phenelzine in the management of intractable migraine. 9 An animal model linking neural and vascular factors applicable to migraine was put forward as the result of experiments by Goadsby and Lambert in our laboratory. 10 Collaboration between Peter Goadsby in our Sydney laboratory and Lars Edvinsson in Uppsala 11 showed that the content of calcitonin gene related peptide was increased in jugular venous blood during migraine headache.