Dr. Shapira's Chicago Headache Blog

* required |Privacy Policy

Thursday, May 26, 2011


There are many different kinds of Migraines and headaches. They all share the same basic features, a common pattern that is frequently seen with migraine is an initial dull ache that develops into a constant, throbbing and pulsating pain that can be experienced in the temples, front or back of one side (or both sides)of the head. The pain is usually accompanied by nausea and vomiting, and sensitivity to light and noise.

A common factor in almost all headaches and migraines is the involvement of the Trigeminal Nerve. Treating migraines and other headaches without drugs can frequently be easily accomplished by changing the neural input into the trigeminal nervous system. TMJ disorders (TMD) are often called "The Great Imposter" I strongly recommend that anyone who suffers from Migraines, Tension-Type Headaches, Chronic Daily Headaches or other chronic head and neck pain read

Two of the most common types of migraine are "migraine with aura" or "Classic Migraine" and "migraine without aura" or "common migraine".

Frequently patients with severe headaches are diagnosed as having "migraine" when they actually have a severe tension headache, muscular headache or cervicogenic headache which can present as a migraine. Many patients and physicians can are fooled into thinking every severe headache is a migraine. Severe headaches are frequently neuromuscular in orgin and easy to alleviate or eliminate. This can lead to the wrong treatments being utilized that while helpful they are not ideal and can increase headache frequency and/or drug overuse.

Rebound headaches and drug overuse headaches are among the most difficult to treat because in addition to the original problems we now are also dealing with a medication caused disorder.

The Common Migraine or Migraine without Aura
because the headache is associated with changes in the size of the arteries inside the skull and in the head and neck. The blood flow to the anterior two thirds of the meninges of the brain is controlled by the trigeminal nerve and this type of headache can frequently be eliminated without drugs with a neuromuscular orthotic that stops the nociceptive input to the brain from the fifth cranial nerve or trigeminal nerve. Neuromuscular Dentistry is most effective when it is ussed to intervene before the pre-headache phase when blood vessels constrict; at the time vascular dilation occurs the migraine begins. The The inflamed as well as swollen blood vessels are believed to be the cause of migraine pain and are caused by neurally mediated inflammationand by increasing the pressure on the swollen walls of the blood vessels. Neuromuscular Dentistry is more effective at preventing or eliminating migraines then a stopping them in the middle of an acute attack.

Migraine sufferers may experience only occasional episodes while others have repetitive migraines two to four times per month. Other patients can get continuous migraines that very in intensity. Most migraine headaches last at least four hours, although very severe ones can last up to a week. I recently treated the wife of a physician who had a continuous headache for over 50 years that was eliminated after only two visits. This is unusual but not unheard of when utilizing neuromuscular dental orthotics. Headaches may begin at any time of the day or night; but when they has a TMJ (TMD) disorder and/or sleep apnea. Migraines rarely awaken a person from sleep but morning headaches frequently can convert into full blown migraines. These morning migraines are especially easy to treat with a neurmucular diagnostic orthotic.

Classic Migraine or Migraine with Aura are about a third of the migraine population. These are also trigeminally innervated migraines and when treated by a neuromuscular orthotic may give a different response. I have seen patients who still experience the aura but the pain never follows. Depending on the triggers that percipitate the migraines the orthotic will often decrease the severity and frequency of these headaches but not completely eliminate them

Migraine sufferers frequently experience visual problems during the headache. Migraine that begins with an aura is usually a manifestation of neurological symptoms. These symptoms are most frequently associated with the trigeminal nerve and the aura begins from five to thirty minutes before the actual onset of the headache. Neuromuscular dentists will frequently use Sphenopalatine ganglion blocks to head off this type of migraine before it hits. Once these migrines are in full swing standard migraine medications are the best way to limit and control pain.

I usually will teach patients how to self administer SPG blocks (sphenopalatine ganglion blocks) with local anaesthetic intranasally applied with a Q-tip. Patients may see wavy or jagged lines,wierdly moving blobs reminescent of Lava lamps, squiggles, worms, polka dots or strobe like flashing lights. Any time patients have flashing lights in their eyes they must consider the possibility of a detatched retina. Other symptoms include tunnel vision or blind spots in one or both eyes or vision going black and white and dimming that is similar to being lost in the fog.

Auras can also be non-visual in nature and can involve sounds , dizziness or strange bodily aches or the feeling like something is crawling thru you. It is not uncommon for smells and tastes to be part of an aura and some patients report that the Aura sonunds , tastes and odors can percipitate attacks when they are encountered in real life.

Feelings of numbness or a "pins-and-needles" sensation as well as difficulty in recalling or speaking the correct word can be experienced with migraine but can also be neurological symptoms of a stroke and must be considered serious at all times. Other less common types of migraine include Hemiplegic Migraine, Ophthalmoplegic Migraine, Retinal Migraine, Basilar Artery Migraine and Abdominal Migraine

Many of these other types of migraines can be very difficult to diagnose but it is important to remember they are are mediated by the Trigeminal nervous system and may respond well to treatment with a neuromuscular diagnostic orthotic which can eliminate or drastically decrease both frequency and severity.

Labels: , , , , , , , , , ,

posted by Dr Shapira at 10:14 AM

Welcome to the iHATEheadaches website, please upgrade your Flash Plugin and enable JavaScript.