Summary
The modern understanding of the pathogenesis of migraine, based on the concept that
it is a neurovascular disorder, is often thought to have emerged from the work of
Harold Wolff in the period 1932–1962. However, over the preceding 300 years, from
William Harvey onwards, various hypotheses of the pathogenesis of migraine had been
proposed, a few bearing reasonably strong resemblances to Wolff’s ideas, though based
on less adequate evidence. Many of these earlier hypotheses regarded migraine either
primarily as a vascular (e.g., Willis, Wepfer, Latham) or as a neural disorder (e.g.,
Harvey, Lieving and his ‘nerve storms’). There were also variations around these two
major themes and in the 19th Century a number of neurovascular type hypotheses emerged
assigning a major role in migraine pathogenesis to the autonomic nervous system. In
addition, during the three centuries there were a number of other hypotheses based
on different postulated pathogenic mechanisms, some quite ingenious, which had relatively
brief vogues. No hypothesis has yet proved capable of explaining all the features
of migraine satisfactorily.
Keywords
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Article info
Publication history
Accepted:
December 4,
2004
Received:
October 27,
2004
Identification
Copyright
© 2005 Elsevier Ltd. Published by Elsevier Inc. All rights reserved.
