Nerve Stimulation For Migraine Headaches

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By: Dr. John Conde DC, DACNB Special to the Boca and Delray newspapers

Migraine headaches typically present with a throbbing or pulsating sensation on one sided (unilateral) severe headache, lasting 4-72 hours, and often accompanied by nausea, vomiting, sensitivity to light (photophobia), and sensitivity to sound (phonophobia). The most common site of head pain is the temple region, extending into the forehead and eye on one side (frontal-temporal).  In-fact, the hallmark of a migraine is involvement of the eye. According to the most recent research, migraines are considered to be hereditary in nature.

Current pharmaceutical treatments for migraines excel in acute, abortive care. This means that immediately upon having a migraine a medication is taken which sometimes helps to reduce the intensity of the symptoms. The most common medications prescribed today are from a class called triptans. Although these medications can be effective for the acute episode, they actually can predispose patients to more frequent headaches not to mention a number of side effects.

Exciting current research is focusing on the neurophysiology of migraines and on treatments that are non-pharmaceutical, abortive like the medications for the acute episodes, and that are preventative in nature. It is now believed that a phenomenon termed cortical (brain) spreading depression (CSD) and dysfunction in brainstem cells that are involved in the control and modulation of head and face pain are to blame for migraine headaches. Essentially, brain cells responsible for processing vision, sound, smell, touch, and even movement become very active prior to and during a migraine episode, producing symptoms such as light and sound sensitivities and pain. Auras, a neurological phenomenon experienced 10-20 minutes prior to a migraine involving vision, motor, or speech impairments may also be experienced. It is theorized that this spontaneous activity of brain cells is due to an unhealthy state; a lack of oxygen, appropriate food (fuel), and/or consistent stimulation. Simultaneously an area in the brainstem responsible for controlling head and face pain malfunctions, leading to unbearable pain.

As of late, nerve stimulation has been generating countless research studies with very favorable outcomes. The most popular is termed external trigeminal nerve stimulation (eTNS).  This treatment focuses on activation of the V1 branch of the trigeminal nerve which sits just below the skin’s surface above the eye brow. The trigeminal nerve is the largest cranial nerve and provides sensation to the face via three branches, V1-V3. The therapy is conducted with a device that emits electrical impulses into the nerve. Another treatment that uses electrical impulses is called vagal nerve stimulation (VNS). This treatment involves attaching electrodes to a specific area on the ear where the vagus nerve is easily accessed. Electrical activity is delivered locally. The vagus nerve, like the trigeminal nerve, is a cranial nerve. Both the eTNS and the VNS work on modulating the brainstem cells that are thought to be unstable. These therapies are usually conducted as a part of a targeted treatment plan that includes other brain-based exercises and dietary modifications and developed following a thorough examination.

Dr. John Conde is a Board Certified Chiropractic Neurologist, one of only one thousand in the country. He holds diplomate status through the American Chiropractic Neurology Board. He provides specialized care for difficult cases of back neck pain, numbness-tingling, vertigo-dizziness balance disorders, fibromyalgia, migraines, AD/HD, autism, and dyslexia. His office is located at the Atlantic Grove in Delray Beach, FL and can be reached at 561-330-6096, drconde@thecondecenter.com, and at www.thecondecenter.com