Case Study

Migraine Headaches

MEDICAL HISTORY:

The patient is a 30-year-old female who began to experience migraine headaches at 4 years of age. Headache patterns occur from 1 to 3 times each month and can last up to 3 days. They are triggered by environmental factors, emotional stress, etc. In addition to the headaches which preclude physical activities, she experiences visual symptoms such as temporary loss of vision in the left eye. Over the course of her life, she has been assessed by numerous specialists including ophthalmologists, neurologists, etc. None of these were able to offer any solutions. The patient has taken several analgesics and other medications, which only occasionally provides temporary relief.

PHYSICAL EXAMINATION:

The patient demonstrated a normal range of motion of both shoulders and the thoracolumbar spine. The range of motion of the cervical spine was moderately restricted with regard to lateral rotation, lateral flexion and extension. Some tenderness was noted over the left paracervical muscles. Neurological examination was grossly within normal limits.

DIAGNOSIS:

Chronic Migraine Headaches

DISCUSSION:

The patient received a total of 10 Laser Therapy sessions over the cervical spine. After only 2 sessions, subsequent attacks were less intense and of shorter duration. After 5 treatments, the headaches disappeared completely. The range of motion of the cervical spine was found to be normal and physical examination failed to reveal any significant abnormalities.

RECOMMENDATION FOR FUTURE THERAPY:

To prevent recurrence, weekly treatments should be continued for 4 weeks then reduced to several treatments on a bi-weekly basis and finally monthly up to 5 months or more. They can then be discontinued to determine whether recurrence is possible. This particular patient has not required the use of any pharmaceuticals since treatment session 5.

CONCLUSION:

Laser Therapy is a unique and effective option for the treatment of Migraine Headaches that are almost invariably unresponsive to the medications currently prescribed for the management of this condition.

PATHOPHYSIOLOGY OF CHRONIC MIGRAINE HEADACHES:

Migraine is believed to be a neurovascular pain syndrome with altered central neuronal processing. (activation of brain stem nuclei, cortical hyperexcitability and spreading cortical depression). There is significant involvement of the trigeminovascular system triggering neuropeptide release which can cause painful inflammation in the cranial vessels and the dura mater.

Many potential migraine triggers have been identified; these include the ingestion of red wine, hypoglycemia, excessive afferent stimuli (flashing lights, strong odors), weather changes, sleep deprivation, stress and hormonal influences. Cranial trauma, cervical pain and temporo-mandibular joint dysfunction may also trigger or exacerbate migraine headaches.

Fluctuating estrogen levels are a potent migraine factor. Many females experience the onset of migraine headaches at menarche, severe attacks during menstruation (menstrual migraine) and increased severity during menopause. For most women, migraines are less frequent and severe during pregnancy, although they may become more pronounced during the 1st and occasionally the 2nd trimester. Oral contraceptives and other forms of hormone therapy occasionally increase the severity of the headache and have been associated with cerebro-vascular accident (CVA) episodes in women who have migraines associated with a variety of aura.

Migraine Headaches

Migraine Headaches/>
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