Hemicrania Continua: Successful Treatment with SPG Blocks

New Developments in Improving Quality of Life for Headache and Migraine Patients

A brand new article in Headache (see Abstract below) shows successful treatment of Hemicrania continua with Sphenopalatine Ganglion Blocks.  This is a very exciting development for patients who live with chronic pain of this disorder.

This disorder also responds well to Neuromuscular Dentistry but there is obviously a significant autonomic nervous system involvement in this disorder.  I am pleased to report that I taught a course to approximately 100 dentists at the ICCMO meeting in San Diego and that patients can now see their ICCMO trained Neuromuscular Dentist to treat this disabling disorder.

Top Neuromuscular Dentists can be found at the ICCMO website www.ICCMO.org

Patients with Hemicrania continuam , migraines, cluster headaches and other disorders should visit their local ICCMO Neuromuscular Dentist.

http://www.sleepandhealth.com/node/663
http://www.sleepandhealth.com/node/705
http://www.sleepandhealth.com/node/691
http://www.24-7pressrelease.com/press-release/migraine-relief-and-prevention-the-sphenopalatine-ganglion-block-spg-this-amazing-treatment-is-often-referred-to-as-the-miracle-migraine-treatment-doctors-learn-hands-on-techniques-at-iccmo-413955.php

Ira L Shapira DDS, D,ABDSM, D,AAPM, FICCMO

Chair, Alliance of TMD Organizations

Diplomat, American Academy of Pain Management

Regent & Fellow, International College of CranioMandibular Orthopedics

Board Eligible, American Academy of CranioFacial Pain

Dental Section Editor, Sleep & Health Journal

Member, American Equilibration Society

Member, Academy of Applied Myofunctional Sciences
www.ThinkBetterLife.com
www.DelanyDentalCare.com
www.IHateCPAP.com
www.iHateHeadaches.org

Headache. 2016 Mar;56(3):573-9. doi: 10.1111/head.12783. Epub 2016 Mar 1.

Hemicrania continua may respond to repetitive sphenopalatine ganglion block: A case report.

Michelle Androulakis X1, Krebs KA1, Ashkenazi A2.

Author information

Abstract

BACKGROUND:

Hemicrania continua (HC) is a chronic headache disorder characterized by a continuous, strictly unilateral head pain accompanied by cranial autonomic symptoms, which completely responds to indomethacin; however, few alternative treatment options exist for the patients with this disorder who cannot tolerate indomethacin. Sphenopalatine ganglion (SPG) block has been used for the treatment of various headaches, with the strongest evidence for efficacy in cluster headache.

CASE REPORT:

A 52-year-old woman with a 7-year history of HC was evaluated in our clinic for management of her headaches after she had stopped using indomethacin due to a bleeding gastrointestinal ulcer. After failing multiple pharmacologic therapies, she was treated with repetitiveSPG blocks using bupivacaine (0.6 mL at 0.5%) twice a week for 6 weeks and followed by maintenance therapy. This treatment protocol resulted in significant improvement in her headaches, mood, and functional capacity.

CONCLUSION:

SPG block using a local anesthetic may be an effective treatment for patients with HC, specifically for those who cannot tolerate indomethacin, or when this drug is contraindicated.

© 2016 American Headache Society.

KEYWORDS:

chronic migraine; cranial autonomic symptoms; hemicrania continua; indomethacin; sphenopalatine ganglion block; trigeminal autonomic cephalagias

Sleep Problems and Chronic Migraines. New Study At Rush Medical School Looking For Participants

I received this message from a researcher at Rush,where I did research at Rush Sleep Center under Dr Cartwright as a Visiting Assistant Professor starting in 1985-1991 on jaw position and sleep apnea and found that Female TMJ (migraine/headache) patients had similar neuromuscular bite relations as male sleep apnea patients.

"Dr Shapira,

 My name is Megan Crawford and I am a researcher at the sleep center at Rush University Medical Center. It is with great enthusiasm that I read about your practice, and how you emphasize the importance of good sleep. We here in the Rush Sleep Center have become interested in understanding the relationship between sleep and migraine, and whether treating sleep problems would be beneficial for migraineurs with insomnia. I am a principal investigator of a clinical trial testing an online sleep intervention for women with chronic migraines. The online sleep intervention is called SLEEPIO (https://www.youtube.com/watch?v=zv-nn0KTwnw) and has been shown to be effective for individuals with insomnia in a clinical trial (http://www.ncbi.nlm.nih.gov/pubmed/22654196). We are looking for females over 18 who have sleep problems and chronic migraines.

Recruitment can sometimes be challenging, and so I am trying to reach out to local headache/pain clinics that might be interested in spreading the word about this study. It is helpful to have someone that individuals know and trust advertise for the research you are doing on their social media websites (blogs, facebook, twitter etc.), or in monthly pamphlets.

If you would like to speak to me on the phone/via email for more information about the study, please do not hesitate to contact me. I would be very happy to send a few fliers to distribute in your office. I look forward to hearing from you.

Kind regards,

Megan"

e-mail for Megan Crawford is megan_crawford@rush.edu 

Chicago Headaches, Migraines, Cluster Headaches and Sleep Apnea, The Sleep Connection to Chronic Daily Headaches.

There is a connection between Sleep Apnea and all headache types but especially Chronic Daily Headaches, Migraines and Cluster Headaches.  The following article is about treatment of Sleep Apnea not about headaches but most physicians feel these arte opposite sides of the same.  The National Heart Lung and Blood Institute published "The Cardiovascular and Sleep Related Consequences of Temporomandibular Disorders" that clearly spells out these connections.

Anyone who has headaches or migraines and also snores, is tired during the day, wakes with dry mouth or headaches should be evaluated for Sleep Apnea.

Reprinted with permission from:  Sleep and Health Journal

Chicago: Dental Sleep Medicine,Oral Appliances,OA, Oarl ApplianceTherapy, OAT, Mandibular Advancement Therapy, MAD,

Chicago Treatment of Sleep Apnea with Oral Appliance: Oral Appliance Therapy is the new comfortable and effective treatment patients prefer.

Learn More About Oral Appliance Therapy at: www.IHateCPAP.com

In Highland Park and on the Metra Line www.ThinkBetterlife.com

North Shore Suburbs of Chicago http://www.northshoresleepdentist.com/

In Gurnee for Northern Lake County and Southern Wisconsin www.DelanyDentalCare.com

SLEEP APNEA TREATMENT WITH ORAL APPLIANCES, PATIENT TESTIMONIAL VIDEOS:

http://www.northshoresleepdentist.com/ https://www.youtube.com/watch?v=0BxuX9Yso1I

https://www.youtube.com/watch?v=iGjYCuYARuA

https://www.youtube.com/watch?v=f9w9L1miIN4

https://www.youtube.com/watch?v=d4R4xYs_tAE

https://www.youtube.com/watch?v=5TtPmb4uyx4

https://www.youtube.com/watch?v=TcFZ2sRiBAQ

https://www.youtube.com/watch?v=6VNsb6n8mXw

The world of sleep medicine has changed in many ways over the last 40 years. In the beginning most of the sleep apnea patients were old fat men and the treatment was often a tracheotomy. Surgery to remove the uvula, soft palate and reconstrcyt the throat became the rage next in spite of extremely poor results, high morbidity and pain. The CPAP machine was invented by Australian Colin Sullivan and it provided a new world of sleep apnea treatment.

CPAP, or Continuos Positive Air Pressure is basically a Mask, A Hose and a Compressor that takes room air and forces it through the hose and mask and into the nose, mouth or both and into the lungs. It actually works to stent the airway open.

The first CPAP machines were crude, loud, bulky with uncomfortable masks and heavy hoses that delivered dry air. Most patients id not like or use CPAP due to discomfort but it was effective. In fact,only 25 % of patients actually used their CPAP machines all night on a regular basis.

The newest machines are quiet, humidified small, sleep and much more comfortable with hundreds if not thousands of possible combinations of masks, hoses (now heated) humidifiers , monitoring, and comfort feature like ramping, APAP, BiPAP and more.

Has CPAP usage expanded? Unfortunately only about 25% of patients use their machine as directed and most do not even meet the medicare guidlines of four hours/ night four nights a week. That combination leaves 70% of sleep Apnea untreated in those patient.

The big secret not told to most patients struggling with CPAP is that at least 60% of patients fail CPAP and give it up entirely. The scandalous part of this is that the majority of patients now receive no treatment and many are not informed about oral appliance therapy, the comfortable alternative to CPAP.

Oral Appliance therapy was a Chicago invention or at least was born into Chicago thanks to the mother of Oral Appliance Therapy Dr Rosalind Cartwright of Rush medical school who published the first peer reviewed articles on oral appliance therapy with the TRD or Tongue Retaining Device and importantly also was the first sleep expert to publish on position sleep apnea.

Positional Sleep Apnea treatment combined with oral appliance therapy actually makes oral appliance therapy a first line treatment for the majority of patients with Obstructive Sleep Apnea.

It should interest everyone who has had a problem with CPAP that Colin Sullivan, the man who invented CPAP utilizes an oral appliance to treat his sleep apnea. Dr John Remmers a Canadian physician who
invented the term Sleep Apnea is an enthusiastic supporter of oral appliance therapy as the first line treatment of Obstructive Sleep Apnea.

The number one reason patients don't use CPAP is "I Hate CPAP!!" The website I created www.IHateCPAP.comwas not named because I hate CPAP but was named because it was the number one reason patients gave when they came looking for an oral appliance treatment of Sleep Apnea. The I Hate CPAP website created a stir in the field of Dental Sleep Medicine and was on Radio, TV, Newspapers, Magazines and Social Media. It brought floods of patients who hat abandoned CPAP back to the field of sleep medicine. It was partially responsible for a boom in sleep treatment as patients were willing to have sleep tests if there were chices other than CPAP and ineffective painful surgery with low efficay and high levels of morbidity.

Politics blew in a powerful storm primarily due to the power and money of companies who made CPAP. I Hate CPAP was banned from Academy of Sleep Medicine and Academy of Dental Sleep Medicne meetings and I was actually told by an oral surgeon and past president of the AADSM that it was better to let people die then market I Hate CPAP! This in spite of the fact that 60% of patients abandoned CPAP. I hate CPAP was found by hundreds of thousands of patients who returned to treatment and far more who learned about oral appliance therapy for sleep apnea.

When I Hate CPAP first marketed we could get hudreds of phone calls a week from Illinos, across the country and around the world. These were patients but also the loved ones or patients who wre concerned about their health and watched them struggling to survive every night while the CPAP machine they hated sat in a closet.

Houston: Neuromuscular Dentistry, TMJ and Migraine Treatment

Chronic Headaches, Migraines Facial Pain can often be allieved or eliminated with Neuromuscular Dentistry.  The first step is an accurate diagnosis followed by a Diagnostic Neuromuscular Orthotic. The Diagnostic Orthotic is utilized to correct the physiology of the head and neck muscles as well as the posture orthopedically diagnostically.

Treatment of Chronic TMJ and Headaches often includes auxillary treatments such as trigger point injections, Sphenopalatine Ganglion Blocks, Prolotherapy and other advanced techniques.

Learn more about Neuromuscular Dentistry and Treatment and elimination of headaches and migraines at the www.IHateHeadaches.org and at www.ThinkBetterLife.com.

View Patient Testimonial Videos about how neuromuscular dentistry, SPG Blocks and other treatments have changed their lives.

Dr Shapira frequently sees long distance patients in his Chicagoland offices and he can help you find a Neuromuscular Dentist in the Houston Area.  All Neuromuscular Dentists are not the same.

There are no Houston Neuromuscular Dentists currently connected to the I Hate Headaches website

TMJ Illinois: Caniofacial Pain, Orofacial Pain, Headaches, Migraines and Cluster Headaches

Headaches and cranialfacial pain  are all problems related to the Trigeminal Nerve, also known as the dentist's nerve it is involved in almost 100% of all headaches and migraines.  Trigeminal Neuralgia and trigeminal neuropathies are also part of the same problem.

Though patients are usually unaware of the trigeminal nerve dentists, ENT's, Neurologists all know it to be the key input to brain and is involved in 100% of all headaches.  Neuromuscular Dentistry is the best way to decrease noxious input to the CNS.

Treatment usually includes a Diagnostic Neuromuscular Orthotic often received by the patient on their first visit after their consultation visit.  Long distance patients can receive at the same visit of initial consultation.

Visit www.ThinkBetterLife.com to start a process to eliminate and or alleviate (some, most, or all) of  your pain.

Dr Shapira see's patients from across the Chicago metropolitan area, the midwest and across the country.  Special arrangements can be made for long distance patients.

Listen to actual patients on you tube videos describe treatment with Dr Shapira.

Morning Headache, Sleep Apnea and CPAP Alternatives

Sleep Apnea is one of the main causes of morning headaches.  CPAP is usually the first treatment option for sleep apnea. but most patients don't use it.  Migraines, chronic daily headaches, cluster headaches and tension headaches are all associated with poor sleep.

CPAP is the Gold Standard for Treating Sleep Apnea.  It is a wonderful invention of  Professor Colin Sullivan  PhD, BSc (Med), MB, FRACP in Australia and it has saved thousand of lives and improved the quality of life for millions.

When CPAP treatment is successful it is amazing treatment but unfortunately it fails 60% of the patients who are prescribed CPAP.

The good news is that oral appliances are an excellent alternative to CPAP that are preferred by 95% of patients offered a choice.  It is so successful that even Professor Colin Sullivan who invented CPAP personally utilizes an oral appliance both for comfort and efficacy!

Information on Chicago Providers of Oral Appliance treatment for CPAP is available at the end of this post.  I have opened a Chicago North Shore office dedicated to treating Sleep Apnea, Snoring and TMJ disorders that is conveniently located on the Metra a very short walk from the Fort Sheridan Metra Station.
North Shore Sleep Dentistry
3500 Western Ave #100, Highland Park, IL 60035
847-533-8313

Almost every complaint patients have with CPAP can be improved or eliminated with a professionally fitted well designed appliance that is patient specific.

Failure of CPAP is almost 100% a patient compliance issue.  Patient complaints about CPAP include:

I HATE CPAP!  I Hate the Mask!, I hate the hose!

Claustrophobic feelings from the CPAP  mask and hose.

Dermatologic problems includung facial sores, ulcers and CPAP related acne.

CPAP noise is a complaint from both CPAP users and their bedmates.

Infections in the sinus regions from CPAP use.  (partially Cleaning issue)

Asthma issues from CPAP  (partially Cleaning issue)

Bronchitis from CPAP  (partially Cleaning issue)

Pneumonia from CPAP   (partially Cleaning issue)

Problems with travel related to CPAO

CPAP Mask Discomfort

CPAP Mask leaks

Headache, neckache and backache issues from CPAP related to sleep position,

Dry Mouth

Dry Eyes from CPAP mask leakage

CPAP inconvenience

Don't like cleaning mask and hose

Pain to travel with CPAP

REGARDLESS OF THE ISSUES WITH CPAP AND CPAP MASKS IT IS ESSENTIAL THAT SLEEP APNEA BE TAKEN SERIOUSLY AND TREATED.

UNTREATED SLEEP APNEA CAN BE DEADLY RESULTING IN HEART ATTACKS AND STROKES.  WHEN SUPREME COURT JUSTICE ANTHONY SCALIA DIED IT IS SUSPECTED IT WAS A DIRECT RESULT OF NOT USING HIS CPAP FOR ONE NIGHT!

One study has shown that patients with moderate sleep apnea patients who are not treated have a 36% decrease in 8 year survival compared to those who were treated.

Patients with untreated apnea aresix times more likely to have motor vehicle accidents and often have trouble at work, school and home.  Marital strife is common due to excessive daytime sleepiness and poor cognition in patients with untreated sleep apnea.

I have been treating sleep apnea for over 34 years.  When I first became an Assistant Professor at Rush Medical School back in 1985 the average patient was an older male usually weighing 250-600 pounds and Severely ill.

Over the last 34 years I did research at Rush Medical School in the 1980's until 1991.  I returned in the 1990's and treated patients at Rush Sleep Service until early this century.  I have taught Dental Sleep Medicine to hundreds of dentists in the US and Internationally.  My most recent course was at Advocate Good Samaritan Hospital on February 29, 2016.  Other recent courses were at the International College of CranioMandibular Orthopedics in both the US and Argentina.

Currently, most of the lectures I give are on the common developmental aspects of TMJ, Sleep Apnea, ADD, ADHD, Dyslexia and working to catch children as early as possible prior to permanent changes in physiological development and brain development/ maturation.

It is now possible to decrease and  prevent many of these problems by early epigenetic orthodontic / orthopedic treatment.  It is also sometimes possible to offer permanent cures of sleep apnea in adults by utilizing Epigenetic Orthodontic treatment with the DNA Appliance and the mRNA version of the DNA Appliance.

Today we know that sleep apnea affects old and young, male and female obese and non-obese patients and that it frequently affects children and infants and then carries with them through life.

Short Term memory loss is associated with untreated sleep apnea and when there is a family history of Alzheimers or Dementia it is recognized in can cause more rapid onset of symptoms at a younger age with more profound disease.

Fro Sleep Apnea Treatment in the Chicago Metropolitan area:

I practice in Gurnee, Il at Delany Dental Care.  847-623-5530
310 S Greenleaf, Gurnee 60031    www.DelanyDentalCare.com

In Highland Park   at 3500 Western Ave   847-533-8313

www.NorthShoreSleepDentist.com

www.ThinkBetterLife.com