Vascular Effects of Nitric Oxide: The Relation to Migraine

Migraine may manifest itself in many ways and the syndrome is afflicting approximately ten percent of the worlds population. The peak incidence of the syndrome occurs in adolescents and young adults, and the prevalence is about three times as high among females than males (Staffa et al., 1994). The diversity of symptoms and the potential confusion with other types of headaches, such as tension-type headache and cluster headache, has lead to the formulation of diagnostic criteria by the International Headache Society (Olesen et al., 1988). These criteria discern between two main types of migraine. The first, migraine without aura, was previously known as common migraine and is characterized by recurrent attacks of intense headache lasting 4 to 72 hours. The headache is commonly unilateral, pulsatile and throbbing in nature. The pain is often accompanied by anorexia, nausea and vomiting, as well as aversion to noise and light (phonophobia and photophobia). In the second type, previously known as classical migraine, headache is preceded by neurological symptoms called aura symptoms. The classic aura includes visual disturbances, like scintillating scotoma and fortification spectra, that drift across the visual field. In addition, somatosensory symptoms may occur as a feeling of numbness (pins and needles) slowly ascending fi'om the fingertips to the shoulder (Spierings, 1988; Blau, 1992). The duration of the aura phase is often limited to 60 minutes, but may outlast into the headache phase.

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