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Sunday, March 8, 2015

Migraine: New Article in Cephalgia: Targeting pericranial nerve branches to treat migraine: Current approaches and perspectives.

This new article in Cephalgia (PubMed Abstract below) discusses evidence that interventions targeting peripheral Nerves are useful.

This is not new information to anyone who has experienced relief and elimination of Migraines from occipital Nerve Blocks or SphenoPalatine Ganglion Nerve Blocks.  Both of these nerve blocks can be safely and efficiently used to decrease, treat and eliminate migraines.

The Sphenopalatine ganglion block is easy for patients to self administer at home to prevent migraines.

Neuromuscular Dentistry has shown thousands and thousands of patients that correction of craniomandibular problems can decrease and eliminate migraines by changing the input into the Trigeminal Nervous System.  All headaches and migraines are mediated in part of fully by the Trigeminal Nerve and the TrigeminoVascular System.

There is a massive amount of input into the Trigeminal Nervous system from proprioception that passes thru the mesencephalic nucleus.  The mesencephalic nucleus is very specialbecause it does not contain chemical synapses.  The neurons are electrically coupled unlike other central nevous system (CNS) ganglia.  The mesencephalic nucleus is the only CNS Ganglia to contain cell bodies of a primary afferent nerve.  The Trigeminal Ganglion is the primary sensory nucleus of the Trigeminal Nerve.

Trigeminal Neuralgia is sometimes treated by destroying parts of the Trigeminal Ganglion with thermocoagulation or injection of glycerol.

Another well known procedure for preventing and treating migraines is osteopathic and chiropractic treatment.  Especially effective are upper cervical chiropractic techniques used by NUCCA and Atlas-Orthoganol Chiropracters.

A very dfferent type of perpheral stimulation of the Trigeminal Nerve can decrease migraine.  Humans smell Menthol with their Trigeminal Nerve. The use of topical menthol is an effective topical pain treatment but smelling of menthol and activation of the Trigeminal Nerve may account for much of this action.    Activation of the antitussive effects of menthol  "occur secondary to the activation of TRPM8+/TRPV1− nasal trigeminal afferent neurons."  (http://jap.physiology.org/content/115/2/268).
These effects were the reason cigarrette companies added menthol .

The trigeminal system is unique in its ability to smell and taste Menthol in a different manner than olfactory nerve (smell) , chord tympani of facial nerve (taste), posterior third of tongue tastefrom Glossopharyngeal nerve.
Smells and taste are frequently associate with migraines as percipitating factors, Auras and can be used in a preentive manner.

 2015 Mar 3. pii: 0333102415573511. [Epub ahead of print]

Targeting pericranial nerve branches to treat migraine: Current approaches and perspectives.



Migraine is a highly prevalent neurological disorders and a major individual and societal burden. Migraine is not curable at the present time, but it is amenable to acute symptomatic and preventive pharmacotherapies.


Since the latter are frequently unsatisfactory, other treatment strategies have been used or are being explored. In particular, interventions targeting pericranial nerves are now part of the migraine armamentarium. We will critically review some of them, such as invasive and noninvasive neurostimulation, therapeutic blocks and surgical decompressions.


Although current knowledge on migraine pathophysiology suggests a central nervous system dysfunction, there is some evidence that interventions targeting peripheral nerves are able to modulate neuronal circuits involved in pain control and that they could be useful in some selected patients. Larger, well-designed and comparative trials are needed to appraise the respective advantages, disadvantages and indications of most interventions discussed here.
© International Headache Society 2015 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.
 2011 Aug 25;189:377-83. doi: 10.1016/j.neuroscience.2011.04.065. Epub 2011 May 7.

Perception of specific trigeminal chemosensory agonists.


The intranasal trigeminal system is a third chemical sense in addition to olfaction and gustation. As opposed to smell and taste, we still lack knowledge on the relationship between receptor binding and perception for the trigeminal system. We therefore investigated the sensitivity of the intranasal trigeminal system towards agonists of the trigeminal receptors TRPM8 and TRPA1 by assessing subjects' ability to identify which nostril has been stimulated in a monorhinal stimulation design. We summed the number of correct identifications resulting in a lateralization score. Stimuli were menthol (activating TRPM8 receptors), eucalyptol (TRPM8), mustard oil (TRPA1) and two mixtures thereof (menthol/eucalyptol and menthol/mustard oil). In addition, we examined the relationship between intensity and lateralization scores and investigated whether intensity evaluation and lateralization scores of the mixtures show additive effects. All stimuli were correctly lateralized significantly above chance. Across subjects the lateralization scores for single compounds activating the same receptor showed a stronger correlation than stimuli activating different receptors. Although single compounds were isointense, the mixture of menthol and eucalyptol (activating only TRPM8) was perceived as weaker and was lateralized less accurately than the mixture of menthol and mustard oil (activating both TRPM8 and TRPA1) suggesting suppression effects in the former mixture. In conclusion, sensitivity of different subpopulations of trigeminal sensory neurons seems to be related, but only to a certain degree. The large coherence in sensitivity between various intranasal trigeminal stimuli suggests that measuring sensitivity to one single trigeminal chemical stimulus may be sufficient to generally assess the trigeminal system's chemosensitivity. Further, for stimuli activating the same receptor a mixture suppression effect appears to occur similar to that observed in the other chemosensory systems.
Copyright © 2011 IBRO. Published by Elsevier Ltd. All rights reserved.

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posted by Dr Shapira at 7:27 AM

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