Headaches or Migraines

What is a Migraine?

Medical Definition

A Migraine is a severe headache, which can last anywhere from two hours to three days. This headache can occur on one side of the head or both sides. People usually describe the pain as pulsating, throbbing or pounding and debilitating. It often gets worse during physical activity or even if you move a little and is accompanied by disturbances of vision and/or nausea, extreme pain and vomiting. Some people become extremely sensitive to sound and light during migraine attacks.

Symptoms

Migraines can begin at any time from childhood through adulthood and may progress through 4 stages prodrome, aura, headache and post-drome.  You may or may not experience all the stages. However, MIGRAINES are diagnosed not by medical tests but by symptoms the person may be experiencing as there is no specific test to diagnose migraines.

Prodome

One or two days before a migraine, you may notice subtle changes that warn of an upcoming migraine, including:

  • Constipation
  • Mood changes can range  from depression to euphoria
  • Food cravings
  • Neck stiffness
  • Increased thirst and urination
  • Frequent yawning and or fatigue

Aura

The aura may occur before or during migraines. Some people experience migraines without aura which can range from vision, sensory, speech or motion disturbances. Which usually start slowly and build up over time lasting for several minutes.

Examples of migraine aura include:

  • Visual phenomena, such as seeing various shapes, bright spots or flashes of light
  • Vision loss
  • Pins and needles sensations in an arm or leg
  • Weakness or numbness in the face or one side of the body
  • Difficulty speaking
  • Hearing noises or music
  • Uncontrollable jerking or other movements

Sometimes, migraine with aura may be associated with limb weakness (hemiplegic migraine).

Attack

The frequency with which Migraine headaches occur varies from person to person and usually lasts from four to 72 hours if untreated. Migraines may be rare or strike several times a month. During a migraine, you may experience:

  • Pain on one side or both sides of your head
  • Pain that feels throbbing or pulsing
  • Sensitivity to light, sounds, and sometimes smells and touch
  • Nausea and vomiting
  • Blurred vision
  • Lightheadedness, sometimes followed by fainting

Postdrome

The final phase, known as post-drome, occurs after a migraine attack. You may feel drained and washed out, while some people feel elated. For about 24 hours, you may also experience:

  • Confusion
  • Moodiness
  • Dizziness
  • Weakness
  • Sensitivity to light and sound

Causes

Migraines may be caused by changes in the brain stem and its interactions with the Trigeminal nerve, a major pain pathway. (Coincidentally this is the main nerve that innervates the teeth and muscles of the jaws and around the eyes.) However, this fact is often overlooked or misunderstood.

Imbalances in brain chemicals — including serotonin, which helps regulate pain in your nervous system — also may be involved. Researchers are still studying the role of serotonin in migraines.

Serotonin levels drop during migraine attacks. This may cause your Trigeminal nerve to release substances called neuropeptides, which travel to your brain's outer covering (meninges). The result is migraine pain. Other neurotransmitters play a role in the pain of migraine, including calcitonin.

This is why your doctor may prescribe medications that regulate these chemicals in your brain like sumatriptan (Imitrex) or zolmitriptan (Zomig). Some common SSRIs include sertraline (Zoloft), fluoxetine (Sarafem, Prozac) and paroxetine (Paxil). SNRIs include duloxetine (Cymbalta) and venlafaxine (Effexor XR).

People may also experience different forms of Migraines and not realize it such as

  • Chronic migraine. If your migraine lasts for 15 or more days a month for more than three months, you have chronic migraine.
  • Status migrainosus. People with this complication have severe migraine attacks that last for longer than three days.
  • Persistent aura without infarction. Usually, an aura goes away after the migraine attack, but sometimes aura lasts for more than one week afterward. A persistent aura may have similar symptoms to bleeding in the brain (stroke), but without signs of bleeding in the brain, tissue damage or other problems.
  • Migrainous infarction. Aura symptoms that last longer than one hour can signal a loss of blood supply to an area of the brain (stroke), and should be evaluated. Doctors can conduct neuroimaging tests to identify bleeding in the brain.

Recent research through Neuro Muscular dentistry has determined that the biggest contributor to Migraines is  - a poor alignment of the bite ...called malocclusion. The muscles of the jaw are forced to hold the jaw in an uncomfortable and unnatural position resulting in the muscles being overworked thereby irritating the trigeminal nerve which innervates these muscles  triggering migraines

Diagnosis

If you have migraines or a family history of migraines, a doctor trained in treating headaches (neurologist) will likely diagnose migraines based on your medical history, symptoms, and a physical and neurological examination.

Your doctor may also recommend more tests to rule out other possible causes for your pain if your condition is unusual, complex or suddenly becomes severe.

  • Blood tests. Your doctor may order these to test for blood vessel problems, infections in your spinal cord or brain, and toxins in your system.
  • Magnetic resonance imaging (MRI). An MRI uses a powerful magnetic field and radio waves to produce detailed images of the brain and blood vessels. which helps your doctors check for tumors strokes and other conditions.
  • Computerized tomography (CT) scan. A CT scan uses a series of X-rays to create detailed cross-sectional images of the brain.
  • Spinal tap (lumbar puncture). Your doctor may recommend a spinal tap (lumbar puncture).

These tests help your doctors check for tumors, strokes and other conditions that may be contributing to your headaches or MIGRAINES.

If all these tests come back negative and have been ruled out by your doctors yet you still experiencing migraines the problem may just be your bite even if you have had braces and think your teeth are straight.

Here at The Cobb Center for Advanced Dentistry our Doctor will evaluate your teeth and bite to determine if this is the cause of your symptoms using advanced jaw EMG's and computerized jaw tracking to determine what your muscles are doing.

IF it is your bite that is causing the symptoms and we are confident we can help you get your life back and live pain-free we will let you know. If we cannot help you we will let you know so we don't waste your time or money or our time either.

Treatment

You may have heard or been told by your physician...that a  Migraine is an incurable condition that can only be managed with lifestyle changes and prescription drugs which only serves to mask the symptoms of the Migraine or chronic headache but doesn't treat the underlying cause.  These do however also come with potential side effects which to lead to more complicated health problems  such as :

  • Pain relievers. Aspirin or ibuprofen (Advil, Motrin IB, others) may help relieve mild migraines.Acetaminophen (Tylenol, others), also may help relieve mild migraines in some people.

    Drugs marketed specifically for migraines, such as the combination of acetaminophen, aspirin, and caffeine (Excedrin Migraine), also may ease moderate migraine pain. They aren't effective alone for severe migraines.

    If taken too often or for long periods of time, the side effects of these medications can lead to ulcers, gastrointestinal bleeding and medication-overuse headaches, as well as liver issues and Nausea.

  • Triptans. Such as sumatriptan (Imitrex), rizatriptan (Maxalt), almotriptan (Axert), naratriptan (Amerge), zolmitriptan (Zomig), frovatriptan (Frova) and eletriptan (Relpax) make blood vessels constrict and block pain pathways in the brain.Side effects of triptans include reactions at the injection site, nausea, dizziness, drowsiness and muscle weakness. They aren't recommended for people at risk of strokes and heart attacks.
  • Ergots. Ergotamine and caffeine combination drugs (Migergot, Cafergot) are less effective than triptans but seem most effective in those whose pain lasts for more than 48 hours, however, these medications may worsen nausea and vomiting related to your migraines, and it may also lead to medication-overuse headaches.
  • Anti-nausea medications. Are usually combined with other medications. Frequently prescribed medications are chlorpromazine, metoclopramide (Reglan) or prochlorperazine (Compro).
  • Opioid medications. Opioid medications containing narcotics, particularly codeine, are sometimes used to treat migraine pain for people who can't take triptans or ergots.
  • Narcotics are habit-forming addictive and are usually used only if no other treatments provide relief.
  • Glucocorticoids (prednisone, dexamethasone). A glucocorticoid may be used with other medications to improve pain relief. Glucocorticoids shouldn't be used frequently to avoid side effects.
  • Cardiovascular drugs. Which are commonly used to treat high blood pressure and coronary artery disease, may also be used to try to treat migraines.
  • Antidepressants. Tricyclic antidepressants may also be used to treat migraines, even in people without depression, however, they can also cause sleepiness, dry mouth, constipation, weight gain, and other side effects.Another class of antidepressants called selective serotonin reuptake inhibitors hasn't been proved to be effective for migraine prevention. These drugs may even worsen or trigger headaches.

    However, research suggests that one serotonin and norepinephrine reuptake inhibitor, venlafaxine (Effexor XR), may be helpful in preventing migraines.

  • Anti-seizure drugs. Some anti-seizure drugs, such as valproate (Depacon) and topiramate (Topamax), seem to reduce the frequency of migraines.In high doses, however, the side effects may be nausea, tremor, weight gain, hair loss and dizziness, diarrhea, nausea, weight loss, memory difficulties, and concentration problems.
  • OnabotulinumtoxinA (Botox). Botox has been shown to be helpful in treating chronic migraines in adults. During this procedure, Botox is injected into the muscles of the forehead and neck thereby trying to paralyze the muscles associated with your jaw and neck functions.  When this is effective, the treatment usually needs to be repeated every 12 weeks and may or may not give you that frozen face looks depending on the amount of Botox used.

Recent research through Neuromuscular dentistry has determined that the biggest contributor to Migraines is  - a poor alignment of the bite ...called malocclusion this is when the top jaw (Maxilla) and lower jaw ( Mandible) are not functioning in harmony.

Here at The Cobb Center for Advanced Dentistry, we use safe and effective methods for determining if your migraines are indeed due to a bad bite and if we can help you correct these problems. If we determine that they are not due to a bad bite or if we are not confident we can help you we will notify you and would not waste your time,  money or our time either.

You have nothing to lose by scheduling an appointment and having us evaluate you except your migraines, symptoms and the medications you may or may not be taking.

SCHEDULE AN APPOINTMENT FOR A COMPLIMENTARY CONSULTATION.