Management Of Headache

Determining if the Neck is the Cause

In Headache and Migraine One of the confusing phenomena about Cervicogenic Headache is that its symptoms can present as Migraine, Tension Headache or even Cluster Headache.2-6 So even though your headache may have been diagnosed as Migraine, Tension Headache, Cluster Headache etc., it may actually be a ‘Cervicogenic Headache’… and there is one feature, which

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Decreasing Migraine Progression

With Cervicogenic Management Recent evidence suggests that migraine is a progressive condition in which over time, episodes become more frequent, more severe, less responsive to medication, and last longer.  Research has shown that by (surgically) treating/removing disorders (which were evident on an MRI scan) in the upper cervical (neck) decreased the long-term worsening of the

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Commentary - Migraine And Calcitonin Gene Related Peptide

Migraine and Calcitonin Gene-Related Peptide

CGRP Under the Magnifying Glass There is now widespread agreement that vasodilation is neither necessary nor of a magnitude to be responsible for migraine pain; migraine is a complex neuronal disorder with vascular epiphenomenon.1 Interest in calcitonin gene-related peptide (CGRP) comes from research which suggests that CGRP could play an important role of migraine pathophysiology.

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Commentary - Medical Diagnosis

Medical Diagnosis

When Managing Headache and Migraine A colleague recently sought to question some of my criticism of medical diagnosis in migraine, see Commentary for Health Professionals, ‘Managing Headache and Migraine: Why Treatment Often Fails‘. My thoughts on my colleague’s comments/queries (in bold italics) follow. Yes there is no test for migraine so the diagnosis is based

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Commentary -Examining The Upper Cervical Spine

Examining the Upper Cervical Spine

In Trigeminal Autonomic Cephalalgias It is refreshing to come across a case study which supports my clinical experience. This study1 describes a woman with a cluster-like pattern of presumably [R] side-locked face and neck pain with associated periorbital and mandibular swelling, tearing, conjunctival injection, and allodynia which was ameliorated by third occipital nerve lesioning –

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Commentary - Trigeminal Autonomic Cephalalgias

Trigeminal Autonomic Cephalalgias

Questions and Answers Q: Of the primary headache types are there some that are more difficult to treat than others? A: Probably the Trigeminal Autonomic Cephalalgia (TACs). The underlying disorder in the TACs is a sensitised brain stem.  The way to determine the relevancy of cervical afferents in headache, Migraine or TAC presentations is reproduction

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