Migraine Case Report

 18 Year Old With Migraine For 6 Months

Introduction

A Migraine is an intense and often debilitating type of headache. The term migraine is derived from the Greek word hemikrania, meaning “half the head,” because the classic migraine headache affects only one side of the person’s head. Migraines affect as many as 24 million people in the United States, and are responsible for billions of dollars in lost work, poor job performance, and direct medical costs. Approximately 18% of women and 6% of men experience at least one migraine attack per year. Currently, one American in 11 now suffers from migraines, more than three times as many are women, with most of them being between the ages of 30 and 49. Migraines often begin in adolescence, and are rare after age 60.

There are two general types of migraines. Eighty percent of migraine sufferers experience “migraine without aura” or a common migraine. In a “migraine with aura,” or classic migraine, the pain is preceded or accompanied by visual or other sensory disturbances, including partial obstruction of the visual field, numbness or tingling. Symptoms are often most prominent on one side of the head or body.

Many options exist for both natural care and allopathic treatment of migraines. This report demonstrates a natural care option when it comes to chronic, long-term migraine. The use of Upper Cervical Specific Care utilizing the Blair method with advanced imaging is the mode of care. The purpose of this study is to explore a theory of correcting an anatomical deficiency (subluxation) commonly found at the Atlanto-Occipital and Atlanto-Axial joints and decreasing the muscle tension in the upper neck that may be creating neurological stress to the body.

Case History

An 18 year old female presented with daily morning migraines for the past 6 months. The migraines were said to wake the patient in the morning and subside by noon. The patient was unable to participate in educational and family activities due to the migraines. The patient’s description of the episodes follow the typical signs of a classic migraine, with an aura and sensitivity to light and sounds. During the six months, the patient was recommended to conduct several tests and various imaging services to discover the inciting factor. The tests were found to be inconclusive and nothing of significance was detected on the imaging.

Upon close examination of the upper cervical spine, including the use of thermographic, range of motion, and neurological tests, an injury to the spine suspected. The sub-occipital muscles were also found to be spastic and tight and the patient had mentioned that there is a correlation between the tension of the muscles and the symptoms experienced. The patient was sent for a specific imaging technique, Cone-Beam CT scan, for an in-depth study of the upper cervical spine. The imaging demonstrated that an injury did exist in the upper cervical spine. The injury was consistent with a segmental dysfunction or chiropractic subluxation at the Atlanto-Occipital and Atlanto-Axial joints in the cervical spine.

I have woken up with a migraine everyday for the past 6 months.

Method of Care

A course of care was pursued to correct the subluxation found at the atlanto-axial joint. The recommended care included an initial correction of the first vertebra and regular visits to evaluate and deliver corrections to the upper cervical spine as needed. The case was managed following the Blair Upper Cervical Specific protocol and included PRILL leg length inequality observations, thermographic pattern studies, posture analysis and neurological tests.

Results

Following the initial upper cervical correction, the patient had not woken up with a migraine or headache for three months. Four corrections were delivered in three months of observation. Due to the outstanding circumstance of traveling nearly six hours to each visit, the patient elected to suspend care after three months. At five months since the initial correction, the patient again started having migraines in the morning. The subluxation pattern was evident with the patient and an additional correction was delivered to favorable results. The patient was able to resume family and education activities without the fear, anxiety and pain of daily migraine episodes.

Jason Alder DC, UCA

Jason Alder DC, UCA

Healthful Chiropractic

Compassionate upper cervical practitioner. Private Practice in McKinney TX. CBCT 3D advanced imaging. Blair and Orthospinology Upper Cervical Specific Techniques.

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Discussion

While the original cause of the upper cervical injury may remain unknown, the procedure to reduce or correct the anatomical misalignment of the spine was shown to be effective in this case. It is of interest to note that the patient had tried a course of care with other therapies and medication to minimal or temporary relief.

Anatomist and researchers have shown that the first two vertebrae are attached to the spinal cord via dentate ligaments to keep the cord centered in the canal. There have been recent studies illustrating the relationship of the upper cervical spine and spinal cord by way of a myo-dural bridge. This is essentially facia or ligamentous tissue from the sub-occipital muscles which are attached to the vertebrae. This tissue is then connected to the dura matter. Should a vertebra shift from it’s normal positioning, it may cause a chain reaction of pulling tissue and irritating the dura matter.

It is unclear whether the dural-bridge was a factor in this case. The patient did have notable muscle tension on the right side of the neck as part of the subluxation pattern. The correction of the dysfunctional segment or subluxation immediately reduced the tension.

Conclusion

This study explores a theory of correcting a subluxation commonly found with injuries to the upper cervical spine and decreasing the muscle tension in the upper neck that may be creating neurological stress to the body. Re-aligning the upper cervical spine will result in less mechanical stress and irritation to the nervous tissue and the individual may experience less frequent and less severe migraine episodes.

References
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  • Smith, JL. Effects of upper cervical subluxation concomitant with a mild Arnold-Chiari malformation: a case study.  Chiropractic Research Journal, 1997;4(2):77-81. Web.

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