Migraine


Shining a New Light on Diagnosis and Treatment of Headaches

Headaches are one of the most common human maladies. Among different head pain conditions, migraine stands out more prominently as through the years countless efforts have been made to understand its nature and find a cure for it.

Migraine Headaches

Migraine headaches are incredibly common with an estimated 12% incidence in the general population. This means that 35 million Americans suffer from this condition. By definition, migraine is an intermittent, moderate to severe disabling headache with typical duration of 8-24 hours if left untreated. Pain is usually throbbing in nature and often affects one side of the head. It is accompanied by sensitivity to light and noise; neck pain and nausea; and characteristically forces the patient to seek shelter in a dark, quiet room for relief and comfort. In about 2.5% of migraine sufferers, the episodic migraine transforms into a chronic form and hence is referred to as chronic or transformed migraine. Many factors influence this transformation. These include; female gender, being Caucasian, increased caffeine consumption, obesity, habitual snoring, depression and/or anxiety. In chronic migraine, frequency of headaches increases to the point that the patient may suffer from 15 headache days per month. This requires a shift in headache management strategies which at times may be different from those of episodic migraines.

The hallmark of migraine is an inherent sensitivity of nerve structures in the brain stem to external triggering factors. This may include sensitivity to light, cigarette smoke, wine, aged cheese and other food ingredients. Once triggered, the nerve structures in the brain stem initiate a cascade of events and electrical impulses that travel in many different directions and also in activation of specific nerve centers such as the sphenopalatine , the Gasserian ganglion and the trigeminal nucleus caudalis. This activation results in the classical manifestations of light sensitivity, throbbing headache, neck pain, nausea and vomiting and stuffiness of the nose. The prognosis of chronic migraine is good provided secondary causes of headache (such as infections) are excluded and preventive treatment is implemented. Avoidance of triggers and modification of risk factors as described above should be addressed.

The most important breakthrough in headache medicine is taking an interventional approach to treatment of headaches which takes advantage of knowledge of pain generators and pain transmission pathways within the central nervous system. Armed with this invaluable weapon, pain transmission and head pain can be interrupted and or significantly diminished by minimally invasive and safe outpatient interventions in the cervical spine, occipital nerves and other nerve centers such as the sphenopalatine and the Gasserian ganglion. For example, sphenopalatine ganglion block is an extremely simple and painless procedure performed by placement of very thin cotton tip applicators (resembling a small q-tip) soaked in a local anesthetic introduced through the nose. This deactivates the sphenopalatine ganglion by simply numbing it, and interrupts the cascade of events involved in transmission of head pain in most headaches including migraine.

Local Migraine Headaches physician

For more information about Migraine Headaches, you may contact your local sub-specialized physician Dr. Benjamin Taimoorazy at Beverly Hills Migraine and Pain Management Institute, Located in Beverly Hills California.

Interview with Dr. Taimoorazy about Headaches