Are cortical spreading depression and headache in migraine causally linked?
Article first published online: 19 NOV 2008
© Blackwell Publishing Ltd
Volume 29, Issue 2, pages 244–249, February 2009
How to Cite
Wolthausen, J., Sternberg, S., Gerloff, C. and May, A. (2009), Are cortical spreading depression and headache in migraine causally linked?. Cephalalgia, 29: 244–249. doi: 10.1111/j.1468-2982.2008.01713.x
- Issue published online: 15 JAN 2009
- Article first published online: 19 NOV 2008
- Received 30 November 2007, accepted 24 May 2008
- cortical spreading depression;
During the past few decades, much controversy has surrounded the pathophysiology of migraine. Cortical spreading depression (CSD) is widely accepted as the neuronal process underlying visual auras. It has been proposed that CSD can also cause the headaches, at least in migraine with aura. We describe three patients, each fulfilling the International Headache Society criteria for migraine with aura, who suffered from headaches 6–10 days per month. Two patients were treated with flunarizine and the third patient with topiramate for the duration of 4 months. All patients reported that aura symptoms resolved completely, whereas the migraine headache attacks persisted or even increased. These observations question the theory that CSD (silent or not) is a prerequisite for migraine headaches.