Headache, Migraine and Depression

It is of no surprise to me that a recent survey showed that headache sufferers were almost 3 times as likely to be depressed than non headache sufferers but who had other issues in their lives.

Let’s consider the lot of a headache sufferer:

little is known about what causes headache or migraine

headache sufferers either experience constant or near constant pain or severe pain

the only management appears to be medication which at best relieves the pain, but doesn’t change the cause (because the cause is unknown)

the doctor is despairing (because he or she doesn’t know what to do next)

Arguably the aforementioned points are more significant than some other issues(?) ….. not much hope is there?

Actually there is … it is amazing that, when after examination of the upper neck reveals the source of headache or migraine symptoms, ‘depression’ lifts – just knowing where the headache comes from leads to significant improvement in one’s outlook.

Cheers

Dean

(Marlow RA, Kegowicz CL, Starkey KN. Prevalence of depression symptoms in outpatients with a complaint of headache. J Am Board Fam Med 2009 Nov-Dec(6):602-3)

© 2009 & Beyond. Watson Headache Institute, All Rights Reserved.

Migraine and Dizziness

Are migraine and dizziness different presentations of a common disorder?

Some patients of mine have presented with dizziness as their only symptom and whilst they are are grateful they do not have to endure the awful pain of migraine or headache, significant dizziness can be disabling …. and of course dizziness is another symptom that many of my headache and migraine patients experience.

Many of those patients in whom dizziness was as the only symptom have responded to mobilisation of the upper three spinal segments (particularly C2-3 – the segment formed by the second and third vertebrae) – the same segments which have the potential to (and I believe do) sensitise the brainstem in migraine and headache conditions.

So I am not surprised by the recent findings of Japanese researchers which indicates that migraine- associated vertigo (dizziness) and Meniere’s Disease share a common condition.

Just as in migraine (I don’t know why!), the cause of Meniere’s Disease is unknown (and controversial) – could it be that the Meniere’s condition arises from a senstised brainstem?

….. all I know it is worthwhile seeking a skilled examination of your neck!

Cheers

Dean

(Murofushi T, Ozeki H, Inoue A, Sakata A. Does migraine-associated vertigo share a common pathophysiology with Meniere’s disease? Study with vestibular-evoked myogenic potential. Cephalalgia 2009;29:1259-1266)

© 2009 & Beyond. Watson Headache Institute, All Rights Reserved.

The Brainstem

I have mentioned the brainstem on a number of occasions.

But what is the brainstem?

The brainstem is an area at the top of the spinal cord, which receives input from (activity of) structures inside the head (including blood vessels) and also from structures of the upper neck (ligaments, joints and the capsules, and muscles) which are supplied by the top three spinal nerves.

The brainstem is also influenced by serotonin and a system known as the Diffuse Noxious Inhibitory Control system . Now all information or activity in relation to headache, head pain and migraine, passes through the brainstem to the higher brain centres where it is interpreted, where the decisions are made!

The Brainstem is the final common pathway for all headache and migraine information.  It is to headache what the black box is to the airplane.

Cheers

Dean

© 2009 & Beyond. Watson Headache Institute, All Rights Reserved.

Hemicrania Continua and Cluster Headache

Are They Related to Cervicogenic Headache?

A diagnosis of Hemicrania Continua just means you have constant pain on one side of your head (just like Cluster Headache) and shares other similar symptoms with Cluster Headache.

Cervicogenic (neck-related) headache, according to the medical model of headache and migraine, is also a one sided headache.

Research shows that Cluster Headache can be relieved by treating the neck and therefore because of the similarity of Hemicrania Continua to Cluster Headache, Hemicrania Continua.

To review the list of posts related to Hemicrania Continua go to the ‘Home Page’ and you can key in ‘ Hemicrania Continua’.

Cheers

Dean

© 2009 & Beyond. Watson Headache Institute, All Rights Reserved.

Demystifying Migraine

Debate as gone on for decades as to whether migraine with aura and migraine without aura are different conditions or just different expressions of the same condition.

Research suggests that they are different expressions of the same condition and that migraine is not about the blood vessels.

My previous posts can be viewed by going to the ‘Home Page’ and keying in ‘Migraine’ to view a list of posts that talk about ‘Migraine’.

Cheers Dean

© 2009 & Beyond. Watson Headache Institute, All Rights Reserved.