What causes migraine?

Updated: Jan 31, 2018
  • Author: William C Robertson, Jr, MD; Chief Editor: Amy Kao, MD  more...
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Answer

Answer

The exact cause of migraine is unknown. Migraine is most likely a heterogeneous disorder and has trigger factors and multiple physiologic causes. Although many of these diseases do not develop until middle age, early recognition of migraine risk factors may help the child to adopt a healthy lifestyle.

The cause of pain in persons with migraine is poorly understood. Migraine pain does involve cranial blood vessels, trigeminal innervation of these vessels, and reflex connections of the trigeminal system with cranial parasympathetic outflow. Most patients experience pain in the distribution of the ophthalmic division of the fifth cranial nerve and/or in the distribution of C2.

Migraine pain may in part be related to the ventral propagation of cortical spreading depression to meningeal trigeminal nerve fibers. This appears to cause the release of a number of vasoactive substances, including neurokinin A, substance P, and calcitonin.


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