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Quasi Epileptic Foci As Generators Of Central Pain And Electrical Abnormalities In Brain Stem Of Migraine Sufferers: A Hypothesis

Even if debated in their significance ,the most objective alterations in migraine (M) are represented by electroencephalographic (EEG) abnormalities. The majority of these modifications in EEG of M sufferers are difficult to classify either as physiological variants or true pathological aspects (1-2). EEG alterations showing pathological features described as epileptoid or epileptic EEG alterations are connected with particular M types ( 3 ) ; however, the most frequent condition in M consists of aspecific patterns (asymmetries in amplitude of alpha activity, higher frequence in slow activity of theta waves), i.e. in minor graphic variations ( 4 ) . With few exceptions, literature confirms a) that these altered EEG are significantly more frequent in M patients than in healthy subjects, b) that the majority of these patients never present clinical fits, and c) that antiepileptic drugs do not exhibit the effectiveness of antimigraine drugs in M therapy. In M, pain is the requisite clinical manifestation. M pain is hardly cassifiable as nociceptive, that is, physiological in nature. M pain could be an expression of a dysfuction of systems of pain transmission and suppression as mainly suggested by its perverted clinical features. All central organic pains are considered as an expression of organic deafferentation ( D A F ) ( 5 ) . Even M pain is suggested to be central in nature and deafferential in its pathogenesis ( 6 ) . The aim of this paper is that of suggesting the possiblity that both M pain and EEG alterations could be an expression of a non organic central DAF syndrome. The explanation of organic DAF is focused on the loss of afferences (7) and therefore on the consequent decrease of pain transmitters. In its turn, neurotransmitter decrease creates both a basal electrical hyperactivity and hypereccitablity in deafferented 2nd and 3rd sensory neurons (8-9). The deafferential hyperactivity is expressed through