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Markus Schürks, MD, MSc

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With great interest I read Dr Rogawski's review titled "Common Pathophysiologic Mechanisms in Migraine and Epilepsy."¹ I would like to comment on 3 aspects.

First, the article suggests that the vascular theory of migraine has been replaced by the neural theory. Most researchers agree that vascular and neural mechanisms are involved in migraine pathophysiology.² While the neural mechanisms have been examined in detail, many studies also suggest that vascular aspects are involved.³ Although the significance of these vascular phenomena and the interrelationship between neural and vascular mechanisms is unclear, I suggest using the term neurovascular with regard to migraine pathophysiology.²

Second, the term hyperexcitability may unequivocally apply to epilepsy pathophysiology, but it is controversial with regard to migraine.⁴ Electrophysiological studies have shown an altered response to repetitive stimuli characterized by a dyshabituation or hyperresponsiveness. While this may be considered a semantic issue, I believe that hyperresponsiveness . . . [Full Text of this Article]

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RELATED ARTICLE

Common Pathophysiologic Mechanisms in Migraine and Epilepsy
Michael A. Rogawski
Arch Neurol. 2008;65(6):709-714.
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RELATED LETTER

Common Mechanisms in Migraine and Epilepsy: A Comment—Reply
Michael A. Rogawski
Arch Neurol. 2008;65(11):1546-1547.
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