Therapeutic implications of the modular headache theory

Abstract

A theoretical approach to understanding the primary headaches not yet classified by the International Headache Society classification system has been developed by the authors. It is proposed that groups of neurons, called modules, become activated to produce each symptom of a primary headache disorder and these modules are linked together to produce a headache. Headaches develop phenotypic stability through the process of learned stereotypy. This theory explains the huge diversity of headache phenomenology. It has implications for the classification, research and treatment of headache patients. The modular headache theory has therapeutic implications by directing us to focus on treatable modules and avoiding unnecessary treatment for less treatable symptoms. This allows for rational approaches to CNS hyperexcitability and incorporates the temporal patterns of modular activation into the patient’s treatment plan.

• chronic paroxysmal hemicrania
• cluster headache
• headache
• hemicrania continua
• migraine
• pathophysiology
• treatment
• trigeminal neuralgia