RESUMO
Shortly after the invention of nitroglycerin (NTG), it was noticed that this substance is capable of inducing a violent headache. Only recently, it became known that this was due to the release of nitric oxide (NO) by NTG. As the molecular mechanism of migraine pain remains to be determined, NTG, being pro-drug for NO, has been used to study the aetiology and pathophysiology of migraine. Such studies with NTG- and also histamine-induced headaches, have led to propose that NO may be the causative molecule in migraine pain. The evidence supporting the role of NO in migraine is discussed, e.g. substances capable of inducing experimental vascular headache do so with NO as the common mediator, while drugs with antimigraine activity inhibit NO and the cascade of intracellular reactions triggered by NO. The importance of NO as a potential initiator of the migraine attack opens new directions for the pharmacological treatment of migraine and other vascular headaches.
Assuntos
Óxido Nítrico/fisiologia , Cefaleias Vasculares/metabolismo , Histamina/efeitos adversos , História do Século XIX , História do Século XX , Humanos , Transtornos de Enxaqueca/história , Transtornos de Enxaqueca/metabolismo , Transtornos de Enxaqueca/terapia , Óxido Nítrico/biossíntese , Doadores de Óxido Nítrico/efeitos adversos , Doadores de Óxido Nítrico/história , Nitroglicerina/efeitos adversos , Nitroglicerina/história , Doenças Profissionais/induzido quimicamente , Doenças Profissionais/história , Cefaleias Vasculares/induzido quimicamente , Cefaleias Vasculares/história , Vasodilatadores/efeitos adversos , Vasodilatadores/históriaRESUMO
Upper and lower limb pain associated to attacks of migraine or cluster headache has been mentioned by many authors since the early descriptions of Liveing, Gowers and Jeliffe. The symptom was also described by Sluder as part of the syndrome of "sphenopalatine ganglion neuralgia." Several authors in the 1920's and 1930's including Cushing and Harris reported cases currently classifiable as migraine or cluster headache with limb pain, but did not accept the mechanisms for pain proposed by Sluder. The scarcity of more recent reports suggests that many patients with migrainous limb pain may be assumed to have other causes for this pain.