Your Headache Solutions » neck

Is Migraine Inherited?

dean — Mon, 07 Dec 2009 00:15:19 +0000

Is migraine inherited?

In a previous post I mentioned a recent survey which reported that 40 per cent of females will experience migraine in their lifetime.

Why is it then, that if three females in a family of ten for example, the assumption is often made that migraine is inherited? This incidence is no more than what occurs in the general population.

This assumption immediately leads to “ …. well you just have to live with it; there’s nothing we can do but manage the attacks.” This is a life sentence and not necessarily the case.

A skilled examination of the neck will confirm or eliminate cervicogenic disorders as the cause of your migraine condition.

Cheers

Dean

(Stewart WF, Wood C, Reed ML, Roy J, Lipton RB. Cumulative lifetime migraine incidence i women and men. Cephalalgia 2008;28:1170-1178)

The Headache and Migraine Sufferers Bill of Rights (cont)

dean — Fri, 04 Dec 2009 00:05:16 +0000

The second ‘bill’:

“The headache sufferer has the right to be taken seriously by the healthcare providers, whose duty it is to take down a relevant history (I have no issues with these!), conduct a relevant physical examination, provide advice and reassurance and prescribe the treatment most advantageous and acceptable to the patient according to current knowledge.”

The issue I have here is with:

conduct a relevant physical examination

It is appropriate that a neurologist conduct the aspects of the physical examination which rule out serious causes of headache – however and with respect the neurologist, physician, or general practitioner are not skilled in examination of the structures of the upper neck – this is where the ‘system’ fails you, the headache or migraine sufferer …. the prognosis, treatment, advice are dependent on the examination, which at this point in time is incomplete; incomplete because your neck has not been examined comprehensively.

So let’s summarise from the first 2 of the 4 ‘bills’ of rights’:

a precise diagnosis is not possible (and besides, does it mean anything)

the nature of the disorder is a sensitised brainstem

the prognosis and best treatment options are dependent on identifying the reason for the sensitisation

the examination you will get will most likely be incomplete because your neck will not be comprehensively examined and therefore one of the most likely reasons for sensitisation (a neck disorder) will not identified ….

…. which means you are likely to be destined to a lifetime of medication which at best manages the symptoms and not the cause.

It is appropriate that as headache or migraine sufferer that you consult your medical practitioner to exclude serious causes of headache (which are extremely rare) but once the various tests have been carried out and there is nothing to find, then a skilled examination of your neck is indicated. Research has shown that information from neck disorders can sensitise the brainstem.

Cheers

Dean

(Members’ Handbook. International Headache Society 2000 Scandinavian University Press)

Headache and Migraine Sufferers ‘Bill of Rights’

dean — Tue, 01 Dec 2009 00:05:59 +0000

Is a diagnosis important?

Some time ago (2000), the International Headache Society, published a Headache Sufferers ‘Bill of Rights’.

The first ‘bill’ is that the headache sufferer has the right to know his/her headache diagnosis as precisely as possible, and to know the nature of the headache disorder, its prognosis and the possible types of treatment.

I would like to spend the next few posts looking more closely at these points:-

“the headache sufferer has the right to know his/her headache diagnosis as precisely as possible”

diagnosis is difficult because it is based on a set of signs and symptoms, and the signs and symptoms of many different headache and migraine forms overlap – perhaps that is why many headache sufferers have been given 2, 3 or even 4 different diagnoses

not only do we have ‘Pure’ Menstrual Migraine, but now ‘MRM’ i.e. Menstrual Related Migraine, Menstrual Tension Headache, Menstrual Hemicrania Continua, Cluster Headache associated with menstruation etc and this is just headache or migraine supposedly associated with the menstrual cycle

the ‘triptans’, supposedly developed to stop the migraine process are effective in other forms of headache e.g. Menstrual Migraine, Cluster Headache, Cervicogenic Headache, and Hemicrania Continua

different headache and migraine forms responding to a range of cervicogenic (neck) treatments e.g. greater occipital nerve blocks, cervical spine stimulators

Is a diagnosis important? As far as I can see, and given the research, a diagnosis does not optimise the management of headache or migraine – it remains a ‘let’s try this and wait and see’ approach – clearly an unsatisfactory situation.

Cheers

Dean

(Members’ Handbook. International Headache Society 2000 Scandinavian University Press)

Migraine and Dizziness

dean — Sun, 29 Nov 2009 00:05:45 +0000

Dizziness is a symptom that many headache and migraine sufferers experience

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)

Hemicrania Continua and Cluster Headache

dean — Wed, 25 Nov 2009 00:15:48 +0000

One sided headache is likely to respond to neck treatment

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

Post-traumatic Headache

dean — Sat, 21 Nov 2009 00:15:50 +0000

Neck disorders can be responsible for headache

Whiplash or post-traumatic headache for some reason seems to be a controversial headache – perhaps because the only explanation for it might be that it results from a neck injury – and there is reluctance by some authorities to accept that neck disorders can be responsible for headache (especially given that post-traumatic or whiplash associated headache presents just like a migraine or tension-type headache?)

To review my previous posts on post-traumatic or whiplash associated headache. Please go to the ‘Home Page’ and key in either ‘Post-Traumatic Headache’ or ‘Whiplash Headache’.

Cheers Dean

Cluster Headache – Another Headache or Migraine

dean — Mon, 16 Nov 2009 00:15:40 +0000

Tension Headache and Migraine are recognised as the most common forms of headache.

Cluster headache is one of the third ‘group’ of headaches – the other headache types in this group are Hemicrania Continua, Chronic Paroxysmal Hemicrania, and SUNCT.

All of the headache types in this third group share similar symptoms with Cluster Headache and either blocking or modifying information from the neck has a beneficial effect on Cluster Headache suggesting that neck disorders not only play a significant role in Cluster headache but perhaps the others(?)

To review the posts on Cluster Headache key in ‘Cluster Headache’ on the ‘Home Page’ and all associated posts will be listed for you to review.

Cheers

Dean

Cluster Headache – Another Headache or Migraine

dean — Thu, 12 Nov 2009 09:42:04 +0000

Tension Headache and Migraine are recognised as the most common forms of headache.

Cluster headache is one of the third ‘group’ of headaches – the other headache types in this group are Hemicrania Continua, Chronic Paroxysmal Hemicrania, and SUNCT.

To review the posts on Cluster Headache return to the ‘Home Page’ and key in the search term ‘Cluster Headache’.

Cheers

Dean

A Migraine Sufferer’s World

dean — Fri, 06 Nov 2009 09:32:35 +0000

A Receptionist at The Headache Clinic recounted this description of headache and migraine told by one of our patients.

This migraine sufferer suggested that if someone has a pain in their toe it remains fairly localised. Unlike the pain of migraine which seemed to expand outwardly, beyond the head, as the pain of migraine increased. By this she meant the pain moved from the person suffering the headache, into their family, workplace, community until the pain became so intense it was the sufferer’s whole world. In fact (and often) at this stage the sufferer has isolated themselves from their daily life, often retreating to bed or seeking help via Accident and Emergency …… unfortunately an all too common story.

However our goal is for this to be a less common story, achieved without ongoing medication and with a skilled examination of the neck.

Cheers

Dean

Neck Muscles and Migraine

dean — Thu, 05 Nov 2009 01:25:13 +0000

Research suggests neck muscle tenderness is connected to migraine

It is interesting to note that injecting tender neck muscles with trihexyphenidyl (used for muscle disorders and in managing the muscle tremors in Parkinson’s disease) prevented migraine attacks from occurring.

The authors suggested that neck muscle tenderness was closely connected to the migraine process!

Cheers

Dean

(Teramoto J. New therapy to prevent migraine attacks just before onset. Cephalalgia, 29 (Suppl. 1) (2009) 1–166)