Alexander, Kurt M

Alvarez, Luis

Bills, Kyle B

Byers, Cassidy

Elm, Davis

Michelon, Louis

Muhlestein, Tallon

Risdon, Layla

Sant, David W

Small, Christina A

Tate, Natalie

Vincent, Garret

English

eCommons at Roseman University

Chronic Intractable Migraine: A Case StudyNatalie Tate1, Luis Alvarez1, Cassidy Byers1, Davis Elm1, Louis Michelon1, Tallon Muhlestein1, Layla Risdon1, Garret Vincent1, Christina Small1, David Sant1, Kyle Bills1,2, Kurt Alexander1,21) Noorda College of Osteopathic Medicine; 2) Migraine and Neuro Rehab CenterImage 1. C0-C2 Cobb angleBackgroundRecommendationsMigraine and StressCase ReportTreatment ProtocolReferences[1] Begasse de Dhaem O, Robbins MS. Cognitive Impairment in Primary and Secondary Headache Disorders. Curr Pain Headache Rep. 2022 May;26(5):391-404. doi: 10.1007/s11916-022-01039-5. Epub 2022 Mar 3. PMID: 35239156; PMCID: PMC8891733.[2] Eliason, D. (2023, June 22). New Patient First Treatment. Provo: The Migraine and Neuro Rehab Center.[3] Jara Silva, C. E., Joseph, A. M., Khatib, M., Knafo, J., Karas, M., Krupa, K., Rivera, B., Macia, A., Madhu, B., McMillan, M., Burtch, J., Quinonez, J., Albert, T., & Khanna, D. (2022, August 9). Osteopathic manipulative treatment and the management of headaches: A scoping review. Cureus. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9462953/[4] Martini, M. L., Neifert, S. N., Chapman, E. K., Mroz, T. E., & Rasouli, J. J. (2020). Cervical spine alignment in the sagittal axis: A review of the best validated measures in Clinical Practice. Global Spine Journal, 11(8), 1307–1312. https://doi.org/10.1177/2192568220972076[5] Mayo Foundation for Medical Education and Research. (2023, July 7). Migraine. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/migraine-headache/diagnosis-treatment/drc-20360207[6] Murphy A, Knipe H, Hayes J, et al. Cervical spine (flexion and extension views). Reference article, Radiopaedia.org (Accessed on 09 Nov 2023) https://doi.org/10.53347/rID-58732[7] U.S. Department of Health and Human Services. (2023, July 11). Migraine. National Institute of Neurological Disorders and Stroke. https://www.ninds.nih.gov/health-information/disorders/migraine[8] YÜCELI, Ş., & YALTIRIK, C. K. (2019). CERVICAL SPINAL ALIGNMENT PARAMETERS. The Journal of Turkish Spinal Surgery, 30(3), 181–186.This case investigates a connection between occurrence of migraines and a musculoskeletal disorder, the loss of cervical lordosis (CL). It is suggested that the loss of CL leads to strain and weakness in the neck muscles, contributing to the onset of migraines.Medications have been developed for relief and as prophylactics. Alternatively, chiropractic adjustments have been utilized as a treatment for the loss of CL and may have indications for the alleviation of migraine symptoms. A systematic review of osteopathic manipulative treatment (OMT) summarized 15 studies in which OMT methods such as myofascial release and suboccipital inhibition reduced patients’ symptoms immediately post-treatment, reduced the number of migraines per month, and reduced the need for medications[3].Together, these spinal manipulative treatments may prove an effective tool in addressing the musculoskeletal component of migraines.Baseline X-Rays and neurocognitive exams were taken in May of 2023. Her C0-C2 Cobb angle was calculated as 49 degrees with loss of lordosis defined as any measurement over 37 degrees. Additionally, her C2-C7 angle was calculated as 10 degrees, with loss of lordosis defined as any angle under 20 degrees.Her neurocognitive exams showed below average scores in areas such as episodic memory and verbal short-term memory as well as moderate to severe levels of reported stress, anxiety and depression.The patient has since received 6 months of weekly chiropractic, neurocognitive rehabilitation and transcranial vagal nerve stimulation treatments. A follow-up neurocognitive analysis showed a decrease in reported anxiety, depression and overall perceived stress. In addition, she improved in attention, response inhibition, visuospatial processing, and episodic memory. As her treatment sessions continue, data collection is ongoing.• CMT of Cervical Spine, Mechanical Traction, Trigger Point Myofascial ReleaseoGoal: restore normal lordosis• Neurocognitive Rehab/Nerve Stimulation/CBToGoal: help patient with psychological effects from disease• Posture Aid Protocol/ Exercise ProtocoloGoal: help improve cervical spine alignment and range of motionThe above treatments along with lifestyle and dietary changes will hopefully result in an improved quality of life and reduction in overall duration, frequency and severity of migraines for this patient.Image 2.  C2-C7 Cobb angle

Chronic Intractable Migraine: A Case Study

https://ecommons.roseman.edu/cgi/viewcontent.cgi?article=1498&context=researchsymposium

Chronic Intractable Migraine: A Case Study

Abstract

Similar works

Full text

Available Versions

eCommons at Roseman University