SDRM, Université Pierre et Marie Curie, Paris VI, 75252 Paris Cedex 05, France ;, Laboratoire de toxicologie, Faculté de pharmacie, Strasbourg, 67400 Illkirch-Grafenstaden, France ;, Laboratoire de physiologie et pathologie, UPMC, 75252 Paris, Cedex 05, France ;, Laboratoire de physiologie et pathologie, UPMC, 75252 Paris, Cedex 05, France
- Mots-clés : headache, magnesium, migraine, photosensitivity, visual stimuli
- Page(s) : 109-22
- Année de parution : 2005
Clinical and paraclinical data (visual stress tests, electroencephalographic and cerebrovascular photic driving, visual evoked potentials) demonstrate that the concept of photosensitive headache is fully justified. The interictal hallmark of photosensitive cephalalgic patients is potentiation (or sensitization) instead of habituation. The aetiopathogenic mechanisms of photosensitive headache associate hypofunction of the biological clock and magnesium depletion. The new concept of headache due to photosensitive magnesium depletion seems justified. It appears logical to add the treatments of magnesium depletion and of photosensitivity to classical treatment of headache. Prophylactic magnesium treatment relies on atoxic nutritional magnesium supplementation in case of primary magnesium deficiency. Pharmacological doses of parenteral magnesium may be used but may induce toxicity. Therefore it is necessary to know the therapeutic index of magnesium compound used: the larger its value, the greater the safety margin. Treatment of photosensitivity uses various types of « darkness therapies »: darkness therapy through physiologic, psychotherapic, physiotherapic, pharmacologic stimulating techniques and substitutive darkness therapy through palliative treatment. Melatonin is only a partial substitutive treatment of photosensitivity. A new model of photosensitive magnesium depletion with potentiation should be a useful tool for discriminating the most efficient « darkness-mimicking » agent.