Rathnasiri Bandara

Rathnasiri Bandara

Government Base (Teaching) Hospital
Sri Lanka

Title: Migraine and neurological disorders comorbidity: Consideration of sinus hypoxic nitric oxide theory


S M Rathnasiri Bandara is waiting to complete his PhD in 2017 at Faculty of Medicine, University of Peradeniya in Sri Lanka on the topic of paranasal nitric oxide and migraine and working as second in charge in youth friendly clinic at teaching hospital Kandy, Sri Lanka. He has published 2 papers on hypoxic nitric oxide theory (SHNOT) for migraine and psychiatric disorders in a reputed journal. That was related to a new hypothesis connected to paranasal sinus nitric oxide and neuropsychiatric dis orders. He also has served as the President of Human Protection Foundation in Sri Lanka since 2005.


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 paranasal sinus nitric oxide mediated neuro-biophysiological 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 paranasal sinus nitric oxide based description those effects are mainly brought on by the sinorhinogenic impulse distribution of the central nervous system except genetic predisposition. 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 neurological 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 is linked 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.

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