O.S. KHAYRUTDINOVA¹, K.S. KOROLEVA ^2,3, R.A. GINIATULLIN ^2,3, E.I. BOGDANOV¹

¹Kazan State Medical University of the Ministry of Health of the Russian Federation, Kazan

²Kazan (Volga Region) Federal University, Kazan

³University of Eastern Finland, Kuopio

Contact details:

Khayrutdinova O.S. — assistant of the Department of Neurology and Rehabilitation

Adress: 49 Butlerov St., Kazan, Russian Federation 420012, tel. +7-962-562-44-27, e-mail: khayrutdinova.os@gmail.com

Objective — to identify the pathophysiological mechanisms of interaction of migraine and cervicogenic headache with the assessment of clinical phenotypes, to develop approaches to the effective treatment of patients with a combination of migraine and cervicogenic headache.

Material and methods. This research work includes the clinical part and the experimental one.

Clinical part: 120 patients were divided into three groups in a longitudinal prospective study:

1) patients with a combination of migraine and cervicogenic headache — 60 people,

2) patients with a combination of migraine and neck pain — 30 people,

3) patients with a diagnosis of migraine without complaints of pain and restriction of movement in the cervical spine — 30 people.

All patients underwent complex treatment of pathological cervical vertebrogenic factor, a month after the end of which the clinical course of migraine was studied and described.

Experimental part: in order to characterize the effect of dimethyl sulfoxide used in the complex treatment of cervicogenic headache and vertebral pathology of the cervical spine, an in vitro study was conducted, the object of the study was an isolated rat skull (Wistar males, 4-5 weeks old, P 35-40) with preserved innervation in the meninges. In the area of ​​divergence of the middle meningeal artery (MCA), dimethyl sulfoxide was applied in concentrations of 0.1%, 1%, 10% stock solution, and a control was also performed with the stock solution, a total of 16 experiments.

Results. Clinical features of the manifestation and course of migraine in patients with active cervicogenic trigger factor were revealed, and the dynamics of the migraine course in the treatment of cervical trigger factor was evaluated. Using neurophysiological methods, the mechanism of the influence of dimethyl sulfoxide on trigeminal fiber in rats is described. Practical recommendations for the treatment of patients with a combination of migraine and cervicogenic headache, as well as migraine and neck pain are proposed.

Conclusion. This study confirms the pathological effect of cervicogenic headache on the clinical course of migraine.

Key words: primary headache, migraine, cervicogenic headache, dimethyl sulfoxide (DMSO), dimexidum, trigeminocervical complex, neurophysiology.

 (For citation: Khayrutdinova O.S., Koroleva K.S., Giniatullin R.A., Bogdanov E.I. Pathogenetic effect of cervicogenic headache treatment on the clinical course of migraine. Practical medicine. 2019.  Vol. 17, № 7, P. 127-133)

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