Lateralization of Headache: Possible Role of an Upper Cervical Trigger Point

Boquet, J; Boismare, F; Payenneville, Guy; Leclerc, D.; Monnier, Jean-Claude; Moore, Nicholas

doi:10.1046/j.1468-2982.1989.0901015.x

Cited by 9 publications

(6 citation statements)

References 15 publications

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“…The fact that migraine attacks in our patients were strictly unilateral might explain the tendency to lateralization of mechanical pain hypersensitivity. Current results agree with those of previous studies conducted on patients presenting with unilateral headaches, in which unilaterality of musculoskeletal disorders has been demonstrated [17,27].…”

Section: Discussionsupporting

confidence: 92%

Side‐to‐side differences in pressure pain thresholds and pericranial muscle tenderness in strictly unilateral migraine

Fernández‐de‐las‐Peñas

Cuadrado

Arendt‐Nielsen

et al. 2008

Euro J of Neurology

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Previous studies dealing with pressure pain sensitivity or muscle tenderness in migraine have shown conflicting results. Our aim was to explore the differences in mechanical pain sensitivity and pericranial muscle tenderness between patients with unilateral migraine and healthy controls, and to analyse side-to-side differences in both study groups. Pressure pain thresholds (PPT) at cephalic and neck points, plus local and total tenderness scores were blindly assessed in 25 patients with strictly unilateral migraine and 25 healthy subjects. For PPT in the neck there were significant differences between groups (F = 47.029; P < 0.001) and sides (F = 6.363; P < 0.01), and a significant interaction between group and side (F = 5.201; P = 0.02), while PPT in the cephalic point showed differences between groups (F = 11.774; P < 0.001), but not sides (F = 2.838; P = 0.1). The total tenderness score showed significant differences between groups (F = 6.800; P < 0.01) and sides (F = 17.699; P < 0.001), along with a significant interaction between group and side (F = 14.420; P < 0.001). Patients had lower PPT and increased pericranial tenderness on the symptomatic side as compared with the non-symptomatic side and to either side in controls (P < 0.001), whereas no significant differences were identified between the non-symptomatic side and controls (P > 0.9). In migraine patients, PPT levels and muscle tenderness scores were negatively correlated (P < 0.001). The enhancement of local tenderness scores was related to hyperesthesia of specific muscles (sternocleidomastoid, suboccipital, and temporalis) rather than a generalized pericranial tenderness. Future studies should investigate the neuro-physiological basis for the laterality of allodynic and hyperalgesic responses in unilateral migraine.

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Section: Discussionsupporting

confidence: 92%

Side‐to‐side differences in pressure pain thresholds and pericranial muscle tenderness in strictly unilateral migraine

Fernández‐de‐las‐Peñas

Cuadrado

Arendt‐Nielsen

et al. 2008

Euro J of Neurology

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“…Firstly, a significantly higher occurrence of muscle tightness in the neck has been found in patients with CeH compared to patients with migraine and controls (10,11). Secondly, electromyographic activity from the trapezius muscles on the symptomatic side in patients with CeH is higher compared with the non-symptomatic side and controls (12,13). A mental load test led to an asymmetric response of non-voluntary muscle activity which was significantly more increased on the symptomatic side compared with the non-symptomatic side (12).…”

Section: Introductionmentioning

confidence: 90%

Onabotulinum toxin A treatment of cervicogenic headache: A randomised, double-blind, placebo-controlled crossover study

et al. 2011

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“…Hu et al have reported that noxious stimulation of muscle afferents increases the excitability of spinal cord neurons (8). Boquet et al found that upper cervical dysfunctions were located ipsilateral to migraine headaches in 24 subjects presenting with strictly unilateral migraine (9). Based on these findings, it seems plausible that TrPs in head and neck muscles might be an initiating or perpetuating factor for some migraine headaches.…”

Section: Introductionmentioning

confidence: 99%

Myofascial Trigger Points, Neck Mobility and Forward Head Posture in Unilateral Migraine

Fernández‐de‐las‐Peñas

2006

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This paper describes the differences in the presence of myofascial trigger points (TrPs) in the upper trapezius, sternocleidomastoid, temporalis and suboccipital muscles between unilateral migraine subjects and healthy controls, and the differences in the presence of TrPs between the symptomatic side and the non-symptomatic side in migraine subjects. In addition, we assess the differences in the presence of both forward head posture (FHP) and active neck mobility between migraine subjects and healthy controls and the relationship between FHP and neck mobility. Twenty subjects with unilateral migraine without side-shift and 20 matched controls participated. TrPs were identified when there was a hypersensible tender spot in a palpable taut band, local twitch response elicited by the snapping palpation of the taut band and reproduction of the referred pain typical of each TrP. Side-view pictures were taken in both sitting and standing positions to measure the cranio-vertebral angle. A cervical goniometer was employed to measure neck mobility. Migraine subjects showed a significantly greater number of active TrPs (P<0.001), but not latent TrPs, than healthy controls. Active TrPs were mostly located ipsilateral to migraine headaches (P<0.01). Migraine subjects showed a smaller cranio-vertebral angle than controls (P<0.001), thus presenting a greater FHP. Neck mobility in migraine subjects was less than in controls only for extension (P=0.02) and the total range of motion in flexion/extension (P=0.01). However, there was a positive correlation between the cranio-vertebral angle and neck mobility. Nociceptive inputs from TrPs in head and neck muscles may produce continuous afferent bombardment of the trigeminal nerve nucleus caudalis and, thence, activation of the trigeminovascular system. Active TrPs located ipsilateral to migraine headaches might be a contributing factor in the initiation or perpetuation of migraine.

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Lateralization of Headache: Possible Role of an Upper Cervical Trigger Point

Cited by 9 publications

References 15 publications

Side‐to‐side differences in pressure pain thresholds and pericranial muscle tenderness in strictly unilateral migraine

Side‐to‐side differences in pressure pain thresholds and pericranial muscle tenderness in strictly unilateral migraine

Onabotulinum toxin A treatment of cervicogenic headache: A randomised, double-blind, placebo-controlled crossover study

Myofascial Trigger Points, Neck Mobility and Forward Head Posture in Unilateral Migraine

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