Showing posts with label TMJ SPG. Show all posts
Showing posts with label TMJ SPG. Show all posts

Friday, August 25, 2017

Precision Personalized Medical Treatment for Headaches and Migraines: SomatoSensory and Autonomic Nervous Systems

Prevention and Elimination of  all types of headaches including tension headaches, muscle tension headaches, sinus headaches, cluster headaches, migraines and other autonomic cephalgias require careful but deliberate application of a combination of autonomic and somato-sensory approaches to idealization of neural input

Measurement is essential for precision medical treatment! "If it is measured it is a fact otherwise it is an opinion" Barney Jankelson father of the field of precision neuromuscular medical / physiological approach to treatment of dental occlusion and treatment of Trigeminal disorders and TMJ Disorders.

In general treatment for headaches and migraines is far from personalized or precision but rather consists of trial and error treatment with pharmaceuticals. Many neurologists use a "chinese menu approach" of one from column A and 2 from column B" When this is not successful they up the dosage.

100% of Headaches and Migraines are Trigeminally innervated either partially or predominantly. There is only one precision approach to the Trigeminal Nervous System that concentrates on reducing nociception and that is Neuromuscular Dentistry.

The fastest connection in the trigeminal nervous system, the brain or anywhere in the body is the Proprioceptive Mesencephalic Nucleus of the Trigeminal Nerve. This incredibly important area is the only place in the nervous system that has direct electrical conduction of impulses between neurons rather that the more common and slower acting chemical neurotransmitters found in other nerve connections. Only precise personalized precision adjusts of neuromuscular dentistry accurately adjust this crucial and unique area of the brain.

The brain is very complex and there are different chemical neurotransmitters that transmit impulses across neuro-junctions. Much of the pharmaceutical attack on headache symptoms concentrate on altering these neurotransmitters such as serotonin, Norepinephrine, CGRP, Substance P, Acetyl Choline, glutamate (most prevalent and usually excitatory 90% of the time), aspartate, γ-aminobutyric acid (GABA) which is the second most prevalent. Gamma-Aminobutyric Acid, or GABA, which is inhibitory at more than 90% of the synapses that do not use glutamate.

Learn more about the Personalized Precision Medicine Approach to correcting nociptive input into the trigeminal nervous system that is a major cause of all headaches, migraines and autonomic cephalgias at http://www.sphenopalatineganglionblocks.com

Elimination of headaches is different than correction of the nociceptive input into the CNS due to neuroplasticity and previous muscle splinting, taut bands, triggerpoints and other myofascial issues from chronic muscle over-adaptation. Correcting long standing problems requires directly addressing myofascial trigger points and taut bands with ULF-TENS, trigger point injections, spray and stretch, myofascial trigger point therapy, myofascial release and other techniques as well as correcting postural issues throughout the body. Trigger Point Injections as espoused by Dr Janet Travell and David Simons MD is perhaps one of the single most personalized precision types of treatment for headaches, myofascial pain and Fibromyalgia as opposed to the dangerous approach of pharmaceuticals used in a shotgun fashion. There is a place for medications in all these disorders but it should be secondary or tetiarry not primary.

The autonomic nervous system is also a major area of concern and perhaps the best approach is to avoid all psychoactive drugs with their widespread side effects and instead alter the incoming messages into the autonomic nervous system with Sphenopalatine Ganglion (SPG) Blocks which can turn off the Sympathetic Fight or Flight response and allow the Parasympathetic system to predominate with its Feed and Breed or Eat and Digest functions.

Neuromuscular Dentistry was the first to utilize electrical Stimulation of the Sphenopalatine Ganglion and has over a fifty years safety record with remarkable results for patients.  This is due to the position of the Sphenpopalatine Ganglion (also known as Pterygopalatine Ganglion, Meckels ganglion, nasal ganglion and Sluder's ganglion) on the Maxillary branch of the Trigeminal nerve.  While the primary purpose of the Myomonitor or ULF-TENS invented by Dr Barney Jankelson was to relax the Trigeminal musculature and use that to create a neuromuscular occlusion there was also incidental stimulation of the facial nerve and both sympathetic and parasympathetic fibers of the autonomic nervous system.  The Sphenopalatine Ganglion is the largest Parasympathetic Ganglion of the head but it also has sympathetic  fibers from the cervical chain that feeds into it.  Both of these autonomic fibers run though the same trigeminal nerves along side of the somato-sensory fibers.

Neuromuscular Dentistry has an incredible effect on resolving and preventing all types of headaches including tension headaches, muscle tension headaches, sinus headaches, cluster headaches, migraines and other autonomic cephalgias due to this unique combination of autonomic and somatosensory approaches.  Starting treatment with a Diagnostic Neuromuscular Orthotic is the ultimate in precision personalized medicine.

Personalized Precision Medicine is also ideally approached in the autonomic nervous system when patients can self administer SPG Blocks, the same technique used by DR Milton Reder in the best selling book about his practice "Miracles on Park Avenue" which discussed the miraculous "cures" that were obtained with this amazing block first discovered and reported by Dr Sluder in 1908.

This link is video stories of  patients who have had SPG Blocks:
https://www.reddit.com/r/SPGBlocks/

This link is stories of patients treated with Neuromuscular Dentistry
https://www.reddit.com/r/NeuroMuscularDent/

Dr Shapira practices Neuromuscular Dentistry in Highland Park, IL a suburb of Chicago.

Ira L Shapira DDS, D,ABDSM, D,AAPM, FICCMO
Chair, Alliance of TMD Organizations
Diplomat, American Academy of Pain Management
Diplomat, American Board of Dental Sleep Medicine
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
http://www.ThinkBetterLife.com
http://www.DelanyDentalCare.com
http://www.IHateCPAP.com
http://www.iHateHeadaches.org
http://www.SleepandHealth.com
http://www.SphenopalatineGanglionBlocks.com

Monday, February 20, 2017

Cluster Headaches and Trigeminal Autonomic Cephalgias, TMJ Disorders and Neurostimulation

AMAZING MIGRAINE, HEADACHE AND TMJ TESTIMONIALS   (links below)
Various stimulators can be used for treating migraines and cluster headaches. A 50-70% reduction in Trigeminal Headaches was seen by  stimulation of the Deep Brain, the Sphenopalatine Ganglion and with occipital stimulation.  The Trigeminal-Autonomic reflex is key to understanding these types of headaches.
Neuromuscular Dentistry also utilizes stimulation of the Trigeminal Nervous System to create muscle relaxation as well as central effects.  Neuromuscular Dentistry reestablishes a healthy homeostasis within the Trigeminal Nervous System by the use of a diagnostic neuromuscular orthotic.  This treatment allows patients to maintain a healthy neurological state and healthy condition of trigeminaly innervated muscles.  In addition, postural correction also occur which reduce occipital headaches.

The use of neuromuscular dentistry and SPG Blocks or Sphenopalatine Ganglion Blocks can give remarkable long lasting relief.

Permanent correction will prove to curative for a significant number of patients but should only be considered after suitable trial period.  There are many patient videos on Reddit attesting to the amazing effects of neuromuscular Dentistry and SPG Blocks.  Combination of these techniques gives patients multiple pathways to a better quality of life.

I have practiced neuromuscular dentistry since 1980 and learned from Barney Jankelson , the genius who created the field.  I currently practice Neuromuscular Dentistry in Chicago in my two offices in Highland Park and Gurnee.  Treatment of TMJ disorders will frequently also eliminate Migraines, cluster headaches and many other chronic pain conditions.

The Highland Park office website is www.ThinkBetterlife.com

The Highland Park office is www.DelanyDentalCare.com

THE FOLLOWING REDDITS HAVE PATIENT TESTIMONIALS

https://www.reddit.com/r/NeuroMuscularDent/

https://www.reddit.com/r/SPGBlocks/

PubMed Abstract:
 2017 Feb;57(2):327-335. doi: 10.1111/head.12874. Epub 2016 Aug 4.

Cluster headache and other TACs: Pathophysiology and neurostimulation options.

Abstract

BACKGROUND:

The trigeminal autonomic cephalalgias (TACs) are highly disabling primary headache disorders. There are several issues that remain unresolved in the understanding of the pathophysiology of the TACs, although activation of the trigeminal-autonomic reflex and ipsilateral hypothalamic activation both play a central role. The discovery of the central role of the hypothalamus led to its use as a therapeutic target. After the good results obtained with hypothalamic stimulation, other peripheral neuromodulation targets were tried in the management of refractory cluster headache (CH) and other TACs.

METHODS:

This review is a summary both of CH pathophysiology and of efficacy of the different neuromodulation techniques.

RESULTS:

In chronic cluster headache (CCH) patients, hypothalamic deep brain stimulation (DBS) produced a decrease in attack frequency of more than 50% in 60% of patients. Occipital nerve stimulation (ONS) also elicited favorable outcomes with a reduction of more than 50% of attacks in around 70% of patients with medically intractable CCH. Stimulation of the sphenopalatine ganglion (SPG) with a miniaturized implanted stimulator produced a clinically significant improvement in 68% of patients (acute, preventive, or both). Vagus nerve stimulation (VNS) with a portable device used in conjunction with standard of care in CH patients resulted in a reduction in the number of attacks. DBS and ONS have been used successfully in some cases of other TACs, including hemicrania continua (HC) and short-lasting unilateral headache attacks (SUNHA).

CONCLUSIONS:

DBS has good results, but it is a more invasive technique and can generate serious adverse events. ONS has good results, but frequent and not serious adverse events. SPG stimulation (SPGS) is also efficacious in the acute and prophylactic treatment of refractory cluster headache. At this moment, ONS and SPG stimulation techniques are recommended as first line therapy in refractory cluster patients. New recent non-invasive approaches such as the non-invasive vagal nerve stimulator (nVNS) have shown efficacy in a few trials and could be an interesting alternative in the management of CH, but require more testing and positive randomized controlled trials.


KEYWORDS:

hypothalamus; migraine pathophysiology; neuromodulation; trigeminal autonomic cephalalgia