An association between migraine and cutaneous allodynia

Authors

  • Rami Burstein PhD,

    Corresponding author
    1. Department of Anesthesia and Critical Care, Beth Israel Deaconess Medical Center, Boston, MA
    2. Department of Neurobiology, Harvard Medical School, Boston, MA
    3. Program in Neuroscience, Harvard Medical School, Boston, MA
    • Department of Anesthesia and Critical Care, Harvard Institutes of Medicine, Room 830, 77 Avenue Louis Pasteur, Boston, MA 02115
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  • David Yarnitsky MD,

    1. Department of Anesthesia and Critical Care, Beth Israel Deaconess Medical Center, Boston, MA
    2. Department of Neurology, Beth Israel Deaconess Medical Center, Boston, MA
    Current affiliation:
    1. Department of Neurology, Rambam Medical Center, Haifa, Israel
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  • Itay Goor-Aryeh MD,

    1. Department of Anesthesia and Critical Care, Beth Israel Deaconess Medical Center, Boston, MA
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  • Bernard J. Ransil PhD, MD,

    1. Department of Neurology, Beth Israel Deaconess Medical Center, Boston, MA
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  • Zahid H. Bajwa MD

    1. Department of Anesthesia and Critical Care, Beth Israel Deaconess Medical Center, Boston, MA
    2. Department of Neurology, Beth Israel Deaconess Medical Center, Boston, MA
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Abstract

Recent animal studies on the mechanism of migraine show that intracranial pain is accompanied by increased periorbital skin sensitivity. These findings suggest that the pathophysiology of migraine involves not only irritation of meningeal perivascular pain fibers but also a transient increase in the responsiveness (ie, sensitization) of central pain neurons that process information arising from intracranial structures and skin. The purpose of this study was to determine whether the increased skin sensitivity observed in animal also develops in humans during migraine attacks. Repeated measurements of mechanical and thermal pain thresholds of periorbital and forearm skin areas in the absence of, and during, migraine attacks enabled us to determine the occurrence of cutaneous allodynia during migraine. Cutaneous allodynia is pain resulting from a nonnoxious stimulus to normal skin. In 79% of the patients, migraine was associated with cutaneous allodynia as defined, and in 21% of the patients it was not. The cutaneous allodynia occurred either solely within the referred pain area on the ipsilateral head, or within and outside the ipsilateral head. Cutaneous allodynia in certain well-defined regions of the skin during migraine is an as yet unreported neurological finding that points to hyperexcitability of a specific central pain pathway that subserves intracranial sensation. Ann Neurol 2000;47:614–624

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