Non-lateralizing brain PET changes in migraine: phenomenology versus pharmacology?

Matharu et al. (2004) believe that the dorsal rostral pons is probably involved in the pathophysiology of chronic migraine. The clinical distinction from episodic migraine is rather semantic and one that is based simplistically on the frequency of headache attacks rather than any fundamental variation of phenomenology. To maintain perspective, it is important to underscore that the International Headache Society classification as well its revisions (Silberstein et al., 1996) are based purely on phenomenology. Similar PET findings in chronic migraine and episodic migraine are, therefore, expected and not surprising. A series of assumptions sustained by neglect of key pharmacological absolutes underlie current understanding …