Cluster Headache, Migraine and Tension Headache are related – more evidence ….

June 25, 2009 by dean · Leave a Comment 

The brainstem sits at the bottom of the brain

The brainstem sits at the bottom of the brain

Clinical correspondence in the latest Cephalalgia journal reports the presence of ‘cutaneous allodynia’ in two cluster headache patients.

What is cutaneous allodynia? Cutaneous (relating to or affecting the skin) allodynia (is a painful response to a normally non painful stimulus) so in this case there is a heightened, painful sensitivity to touch. This increased sensitivity to touch, along with other symptoms for e.g. photo-phobia (heightened sensitivity to light) and phono-phobia (heightened sensitivity to sound) is a sign of sensitisation of the brainstem.

Research shows quite clearly that the brainstems of migraineurs and tension headache sufferers are also sensitised …. and what do the ‘triptans’ do? they desensitise the brainstem and that is why they are effective in alleviating the pain in migraine, tension and cluster headache – all three headaches originate from the same condition i.e. a sensitised brainstem.



(Katsavara Z, Giffin N, Diener HC, Kaube H. Abnormal habituation of ‘nociceptive’ blink reflex in migraine – evidence for increased excitability of trigeminal nociception. Cephalalgia 2003; 23:814-819

Katsavara Z, Lehnerdt G, Duda B, Ellrich J, Diener HC, Kaube H. Sensitization of trigeminal nociception specific for migraine but not pain of sinusitis. Neurology 2002; 59:1450-1453

Kaube H, Katasavara Z, Przywara S, Drepper J, Ellrich J, Diener HC. Acute migraine headache. Possible sensitization of neurons in the spinal trigeminal nucleus? Neurology 2002; 58:1234-1238

Nardone R, Tezzon F. The trigemino-cervical reflex in tension-type headache. European Journal of Neurology 2003; 10(3):307-312

Nardone R et al Trigemino-Cervical Reflex Abnormalities in Patients with Migraine and Cluster Headache. Headache 2008; 48(4):578-585

Milanov I, Bogdanova D. Trigemino-cervical reflex in patients with headache. Cephalalgia 2003; 23:35-38

Riederer F, Selekler HM, Sandor PS, Wober C. Cutaneous allodynia during cluster headache attacks. Cephalalgia 2009;29:796-798

Sandrini G, Cecchini AB, Milanov I, Tassorelli C, Buzzi MG, Nappi G. Electrophysiological evidence for trigeminal neuron sensitisation in patients with migraine. Neurosci Lett 2002; 317:135-138)

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About dean
Consultant Headache & Migraine Physiotherapist; International Teacher; Director, The Headache Clinic & Watson Headache Institute; PhD Candidate Murdoch University, Western Australia; Adjunct Lecturer, Masters Program, Physiotherapy School, University of South Australia; MAppSc(Res) GradDipAdvManipTher Experienced health practitioners trained in the Watson Headache Approach perform the examination and treatment techniques developed by Dean Watson. These techniques are based on his extensive experience of 7000 headache patients (21,000 hours) over 21 years and are now taught internationally. For your nearest practitioner who has completed training in the ‘Watson Headache Approach’ please refer to the ‘Practitioner Directory’.

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