Some aspects on the pathophysiology of migraine and a review of device therapies for migraine and cluster headache

Neurol Sci. 2019 May;40(Suppl 1):75-80. doi: 10.1007/s10072-019-03828-0.


Migraine is a common, severe disease, affecting the brain and blood vessels, causing much pain, time missed from work and family, and severe disability. It affects approximately 12% of most Western populations studied and affects women three times more than men. Cluster headache is a much less common dysfunction of the hypothalamus, involving the sphenopalatine ganglion and other areas; it causes more frequent, shorter, and even more intense pain than migraine. The pain usually comes in cycles and is associated with ipsilateral autonomic features and associated with irritability and inability to stay still. It affects less than 0.1% of the population and is slightly more prevalent in men than women. Although we have some acute care and preventive medications for both types of headache, no treatment is optimal for each patient and some will not respond well or have significant adverse events to existing therapies.

Keywords: CGRP; Cluster headache therapy; Headache devices; Migraine therapy; Monoclonal antibodies to calcitonin gene–related peptide or its receptor; Pathophysiology of migraine.

Publication types

  • Review

MeSH terms

  • Calcitonin Gene-Related Peptide / blood
  • Cluster Headache / drug therapy*
  • Cluster Headache / physiopathology
  • Headache / drug therapy*
  • Headache / physiopathology
  • Humans
  • Migraine Disorders / drug therapy*
  • Migraine Disorders / physiopathology
  • Pain / diagnosis
  • Pain / physiopathology
  • Pain Management*


  • Calcitonin Gene-Related Peptide