A Clinical Test for Migraine

A Query and Minor Note inThe Journal, Oct. 26, 1946, page 486, stated that "there is no satisfactory method of experimentally inducing attacks of migraine in persons who are susceptible to them." Since 1940 we have been using a test which we find quite specific in precipitating amigraine headache in persons afflicted with them. This test consists in the use of nitroglycerin sublingually. Migraine is a distinct type of headache and should be separated from so-called histamine cephalalgia, which can be precipitated by the subcutaneous injection of histamine base according to the method of Horton.¹It has been fairly well established by Wolff²and his co-workers that the basic mechanism of pain in the migraine syndrome is due to the stretching of the cranial arteries, chiefly the extracranial structures (external carotid artery and its branches). This same mechanism obtains in the headache associated with arterial hypertension. Conversely,