Abstract
Migraine is an extremely common disorder and has co morbidity with many neurological illnesses. After reviewing the neurophysiological and biochemical basis of the research findings and hypotheses of migraine and other neurological disorders I present to the best of my knowledge the first para nasal sinus nitric oxide mediated neurobiophysiological explanation for many neurological disorders. The etiology of neurological illnesses is mainly due to neurotransmitter imbalance, neurodegenerative changes acute and chronic inflammation, effects of hypo and hyper endothelial and neuronal NO levels and genetic predisposition. According to this para nasal sinus nitric oxide based description those effects are mainly brought on by the sinorhinogenic impulse distribution of the central nervous system except genetic predisposition. Moreover, avoidance of the central neuronal influence and stress to the brain in early childhood or young age caused by migraine would help to prevent the progression or aggravation of the neurological illnesses. Indeed this article explains a new pathophysiological initiation between sino rhinogenic nitric oxide effects and neurological disorders and provides an etiologically important Neuro vascular impulse generating pathway to cause or aggravate neurological disorders. Therefore the patients who are clinically suspected of having migraine headache and neurological disorders or along with susceptible neurological disorders should receive comprehensive sinorhinological examination and evaluation based on the sinus hypoxic nitric oxide phenomena. A standard surgical and medical management of migraine that links with the sinus hypoxic nitric oxide theory are suggested to be used for even neurological disorder as a new treatment of neurological illnesses and to prevent the dysfunction of central specific neural circuits.
Highlights
Migraine is a common neurological disorder and affects about 15% of people in developed countries [1], which is co-morbid with many neurological illness such as stroke [2], epilepsy [3], motion sickness [4], vertigo [5], balance disorder [6] and benign intra cranial hypertension [7], Narcolepsy [8]
The neuro pathological explanation for migraine co morbid with neurological illnesses that is due to shearing of common receptors, neuronal tracks and some pathology of blood vessels has been put forwarded
The Hypoxic Nitric Oxide Theory [Sinus Hypoxic Nitric Oxide Theory (SHNOT)] for pathophysiology of migraine [11] can be considered as an additional cause or aggregative pathophysiological mechanism and thereby introduce a new medical and surgical approach for the management of such neurological illnesses
Summary
Migraine is a common neurological disorder and affects about 15% of people in developed countries [1], which is co-morbid with many neurological illness such as stroke [2], epilepsy [3], motion sickness [4], vertigo [5], balance disorder [6] and benign intra cranial hypertension [7], Narcolepsy [8]. The Hypoxic Nitric Oxide Theory [SHNOT] for pathophysiology of migraine [11] can be considered as an additional cause or aggregative pathophysiological mechanism and thereby introduce a new medical and surgical approach for the management of such neurological illnesses. For instances of MRI changes similar to trigeminal stimulation in migraine patients could be observed following the intranasal administration of nociceptive stimulus using the application of ammonia (NO4) [29] and sensory stimulus using CO2 [30] When these gases are compared with the physiological and biological role of sNO it would directly and stimulate neurovascular compartment of the mucosa generating trigeminal impulses and the shear stress in the blood vessels. According to SHNOT migraine can run through family via genetics that may mainly contribute to make the nasal and paranasal anatomy [19] that could be corrected rather than other noncorrectable genetic influence
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