D G A I Jayarathnais is working as a nursing officer in cardiothoracic intensive care at teaching hospital Kandy which is the 2nd largest hospital in Sri Lanka. Her research interest helped her to find what it is the obscured aetiology of migraine pathophysiology in 2010. There she has assisted to Dr. S M R Bandara -the corresponding author of sinus hypoxic nitric oxide (SHNOT) for migraine and psychiatric disorders and his research group to develop the hypothesis and now she is a co-author of the Migraine and neurological disorders comorbidity: Consideration of sinus hypoxic nitric oxide theory. Thus they propose that the underlying mechanisms involve in many neuropsychiatric disorders caused by SHNOT. Ongoing work is focused the therapeutic aspects of reliving hypoxia to paranasal sinuses including reduces nitric oxide production in the related disorders settings


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 we present to the best of our 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 .The hypothesis is named as sinus hypoxic nitric oxide theory (SHNOT) for migraine .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 sinorhinogenic nitric oxide effects and neurological disorders and provides an etiologically important Neuro vascular impulse generating pathway to cause or aggravate someneurological 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