The pain of migraine
Migraine is a debilitating form of headache, often accompanied by sensitivity to sound and light; nausea and vomiting may be present. A migraine may last from four hours to three days.
About 20 percent of sufferers experience "aura", sensory signs and visual disturbances which precede the headache and for some sufferers, the headache is accompanied by earache.
Theories/Speculation
The exact causes of migraine are not fully understood, though it is now generally accepted that the attack begins within the brain, according to Nature Medicine.
The "migraine cascade" begins when nerve cells in the brain become over excited, causing blood vessels within the brain to become inflamed and to supply excess blood to the brain. The Headache Research Center has shown that this is followed by reduction in blood flow as the vessels contract. The mechanisms by which essential chemicals are carried in the brain are also disrupted.
How do we Feel Migraine Pain?
The brain is unable to feel pain. Although the migraine cascade begins within the brain, pain from migraine headaches actually occurs in the membrane which covers the brain (meninges) and the blood vessels, muscles and nerves of the head and neck.
The sensory (feeling) parts of the facial nerve are activated by the changes in the brain and send messages back to the brain. The brain interprets the message to tell us where the pain is and how severe it is.
About the Facial/Trigeminal Nerve
The trigeminal nerve is a complex and very important facial nerve. Although it covers a relatively small area of the body, it is responsible for sending almost 50 percent of the total of sensory information received by the brain.
It sends sensory information to and from: the eye sockets, the teeth and their connecting ligaments, the jaw muscles and joints, the tongue and lips, and the lining of the sinuses and muscles inside the ear.
Why does an Earache Accompany Migraine?
The trigeminal nerve has three major branches, one of which is called the maxillary nerve. This runs behind the cheek bone and is responsible for sensation in the ears.
The migraine cascade activates the trigeminal nerve and the area in which pain is felt depends upon which part of the nerve is activated. If the maxillary nerve is activated then pain will be experienced in the ears.
Summary
Inner ear showing nerve supply from maxillary nerve
The pain felt in the ears during a migraine attack is not a sign that there is any problem with the ears themselves.
Earache may be part of a migraine attack because of the area of the trigeminal or facial nerve which is stimulated by the changes in blood flow and chemicals in the brain.
Tags: facial nerve, maxillary nerve, migraine cascade, nerve activated, trigeminal nerve, within brain, begins within