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MIGRAINE HEADACHES

Proactive treatment options that work

  • The one-year prevalence of migraine is 17.2% in females and 6.0% in males
  • Migraines are the 6th most common cause of disability worldwide
  • Migraine without aura is the most common, accounting for 80% of migraines

A NEW MIGRAINE THEORY

Migraine used to be considered a result of stenosis or narrowing of arteries in the brain, where those arteries constricted and then had a rebound dilation. However, the current theory, the neurovascular theory, holds that the fundamental problem is neurogenic; the trigeminal nerve (main facial nerve) innervates blood vessels in the brain and acts as a feedforward mechanism, facilitating the acute attack but not the causing the actual problem.

STANDARD MIGRAINE (AND CHRONIC HEADACHE) TREATMENTS

The traditional medical model supports intervention with medication and lifestyle changes to help prevent the onset of migraines. During a migraine attack, intervention with medication is also the go-to abortive therapy. Of concern, pharmaceuticals have significant side-effect profiles.

  • Prophylactic Therapies: Include Beta blockers, Tricyclic antidepressants, Topiramate, Flunarizine, MAOIs, Gabapentin 
  • Abortive Therapies: Include NSAIDs, 5-HT1 agonists – triptans, Ergot alkaloids - ergotamine and dihydroergotamine, Narcotic analgesics – oxycodone, codeine, etc.

HEALTH QUEST MIGRAINE TREATMENT OPTIONS

All treatments are non-drug, non-surgical and are safe to be used in conjunction with the majority of concurrent medical therapies.  They can include:

  • Vestibular rehabilitation therapy (VRT) and Ocular Rehabilitation therapy: Treats persistent symptoms of dizziness, headache, poor balance/coordination and visual dysfunction
  • Non-invasive neuromodulation: A research-based, peer-reviewed treatment using vagus nerve, trigeminal nerve and occipital nerve stimulation, which calms overactive nerves and stimulates underactive nerves to strengthen/modulate neural pathways associated with head pain and balance/dizziness
  • Spinal stabilization programs: Evaluation and physical therapy treatments for injuries to the cervical spine, such as whiplash
  • Dietary review: Evaluation of potential dietary triggers, with recommendations for modifications and substitutions

OTHER FORMS OF HEADACHES TREATED AT HEALTH QUEST

  • Headache due to trauma of the head and/or neck, including concussion or whiplash from sports, motor-vehicle accidents, or falls
  • Chronic daily headache
  • Tension-type headache
  • Trigeminal autonomic cephalgias, i.e., Cluster headache

MORE INFORMATION

Diagnosis and prescribed treatment programs at Health Quest are performed by Dr. Sean Grady, DC with PT privileges, CFMP, DACNB. Dr. Grady holds the prestigious Diplomate from the American Chiropractic Neurology Board (DACNB), certifying him as a Functional Neurologist and allowing him to provide, in simple terms, brain rehab for those suffering from a variety of neurological conditions. These conditions include headache/migraine, vertigo/dizziness, stroke, neuropathy, concussion and Mild Traumatic Brain Injury. 

Dr. Grady is also certified as a whiplash and soft tissue injury specialist through the Whiplash Injury Biomechanics and Traumatology program at the Spine Research Institute of San Diego and is pursuing dual Fellowship certification in both Concussion/MTBI and Vestibular Rehabilitation from the American College of Functional Neurology. He is the only certified Functional Neurologist in a 40-mile radius of the Baltimore metropolitan area.

Typically, a Functional Neurologist serves in the same consulting manner as a Medical Neurologist. The difference is that the therapies or applications of a Functional Neurologist do not include drugs or surgery. The treatments are brain-based and follow the principles of neuroplasticity, the notion that the nervous system can change according to the stimulation it is exposed to.

As mentioned above, although the Functional Neurology model does not employ medication or surgery, Dr. Grady will work with other medical providers and specialists to ensure a cooperative and integrative approach to every patient’s health goals.

References

Francesca Puledda, P. J. (2016). Current Approaches to Neuromodulation in Primary Headaches: Focus on Vagal Nerve and Sphenopalatine Ganglion Stimulation. Current Pain Headache Reports.

Goadsby, P. (2012). Pathophysiology of migraine. Annals of Indian Academy of Neurology, S15-S22.

Jasvinder Chawla, M. M. (2017, May 10). Medscape - Migraine Headache. Retrieved from medscape.com: http://emedicine.medscape.com/article/1142556-overview#a2

Lipton RB, Scher AI, Kolodner K, Liberman J, Steiner TJ, & Stewart WF. (2002). Migraine in the United States: epidemiology and patterns of health care use. Neurology, 885-94.