Immunological mechanisms and headache syndromes

The association between pain and inflammation and certain clinical signs le d physicians to suspect a connection between immunological mechanisms and h eadache syndromes even years ago. This review intends to give an overview o f the literature which deals with immunological mechanisms in headache synd romes - with divergent results. Thus,a food allergy as a cause of migraine only seems to be relevant in a few isolated cases. lmmunoglobulins or infec tions do not seem to play a role. Whether the complement system, auto-antib odies, immune cells or cytokines are involved in migraine pathophysiology,s till remains to be determined. With regards to cluster headache,a participa tion of the immune system seems more probable. Although a systemic vasculit is or auto-antibodies probably do not contribute to cluster headache pathop hysiology, reports of an immune activation, especially of T-cells, predomin ate the literature. Nevertheless, the evidence for an immunogenically trigg ered cluster attack is still lacking. In summary, only a mutual modulation of the immune and the pain system can be assumed with certainty.