Cervicogenic Headache


Cervicogenic headache is a result of referred pain from the neck (cervical spine) that is perceived in the head in the form of a headache. Referred pain is when pain occurs in a part of the body other than its true source. Cervicogenic headache is caused by an abnormality of the cervical spine such as tumors, fractures, infections and arthritis.
Cervicogenic headache generally presents as a one sided headache with pain that radiates from the neck through the head, up to the front of the head/behind the eye. Additional symptoms include reduced range of motion of the neck and a worsening headache with certain neck movements or pressure applied to certain spots of the neck.
Suspicious of Cervicogenic headache? Come see us at The Manhattan Center for Headache & Neurology where we can properly assess and treat you! People with possible cervicogenic headache should be carefully assessed by a physician to exclude other causes of headaches. Treatment includes nerve blocks, medications, physical therapy and exercise.
Caroline Pruski, NP

Migraine and Light

Many people who suffer from migraines suffer from sensitivity to light, also known as photophobia. In fact, this is a hallmark symptom of migraine. In fact, it is believed that about 85-90% of people with migraines also experience this symptom.

In many cases, a person having a migraine attack often will isolate themselves in a dark, quiet room to help relieve the symptoms.

Light comes in many different forms, with different wavelengths representing different colors. A recent study found that green light actually reduced intensity of participant’s migraines by about 20% compared to red, blue, and white lights. Although there are no current therapies using green light for migraine sufferers there is definite potential in the future. Blue light, which is associated with electronics including phones and computers, can contribute to the onset of migraines.

For patients living with migraines, it is important not to avoid exposure to light completely which would just increase sensitivity. Avoiding extreme glare and sitting next to windows when possible may help. Also, applying filters through red, yellow, or orange lenses to screens on electronic devices may contribute to prevention.

It is important to talk to your healthcare provider about your symptoms because there may be other reasons you are experiencing the sensitivity to light.

For more information about migraines and light, call and speak to one of our caring providers!

By: Brooke Steiger, NP

Cervical Dystonia

Cervical Dystonia, (spasmodic torticollis) is a painful condition in which your neck muscles contract involuntarily, causing your head to twist, tilt or turn. Symptoms include abnormal head postures (most commonly the chin is pulled toward your shoulder), jerking motion of the head and neck pain that can radiate into the shoulders and headaches. Cervical dystonia can be an exhausting and disabling condition. In most cases of cervical dystonia, the cause is unknown. There is a possible genetic component and at times it can be linked to head, neck or shoulder injuries.
A diagnosis of cervical dystonia is based upon clinical examination, a detailed patient history. There is no specific laboratory or imaging test confirms a diagnosis of cervical dystonia. There are no abnormalities in laboratory or imaging tests. Magnetic resonance imaging (MRI) of the brain is normal, and MRI of the neck does not help with the diagnosis unless compression of the spinal cord is suspected. Electromyography (EMG) is not indicated unless there are additional signs of nerve irritation.
There is no cure for cervical dystonia but treatment focuses on relieving the signs and symptoms. Possible treatment options include botox injections, oral medications that have a muscle-relaxing effect, sensory tricks, heat packs, massage therapy, exercises, stress management techniques and deep brain stimulation.
Call The Manhattan Center for Headache & Neurology! Speak to one of our caring providers!
BY: Caroline Pruski, NP

Acupuncture for migraines

Acupuncture is an ancient form of Chinese medical practice based on the notion of regulation of flow and balance of energy, known as “chi” in Chinese, in the body. It is performed using very small needles to stimulate points on the body in Chinese medicine known as acupuncture points and meridians which correspond to different organs in the body.

In western medical practice, it is believed that acupuncture causes therapeutic effects in the body through micro-injury that temporarily causes an increase bloodflow. Also, some studies have shown that acupuncture increases endorphins in the body that lead to decreased pain levels.

Acupuncture has been found to be helpful in decreasing pain associated with headaches. A large-scale study done in 2012 looked at the effects of acupuncture in several pain conditions including headache and found that it was effective in treating headaches and had effects similar to non-opiate pain medications. Additionally, it is beneficial in helping to treat anxiety, sleep problems, and muscular tightness.

It may be utilized along with medications, massage, and stress-reduction techniques to treat migraines or headaches.

To find out if acupuncture is right for you, speak to your healthcare provider.

By: Brooke Steiger, NP

Migraine & Diet


Some people find that certain foods can trigger their headaches and migraines.
Foods that might trigger migraines and headaches vary quite a bit from person to person. Some people find that wine is a trigger. Others find that chocolate may be a trigger.
Generally, for good health, a diet that is high in vegetables, fruits, and complex carbohydrates and low in junk foods including processed foods. This type of diet also generally works well to keep headaches to a minimum.
For some, not eating frequently enough may be a trigger. For example, skipping breakfast or eating lunch at a later than usual time may bring on a headache.
For more information, talk to your provider about which diet and foods are right for you.

Brooke Steiger, NP

Nerivio Migra, NOW AVAILABLE AT MCHN! 1st Smartphone controlled acute migraine-relief wearable device!

The FDA granted a de novo request for approval of a smartphone-controlled electroceutical for the acute treatment of migraine with or without aura in adult patients who do not have chronic migraine. The Nerivio Migra is a wearable device that goes on the upper arm and this device is controlled from your smartphone.
It was invented by Theranica, an Israeli company, with the goal of relieving migraine pain without the side effects of medication.
Nerivio Migra is the 1st FDA approved low cost, low side effect wearable device for the acute treatment of migraine.
The Nerivio Migra has 2 electrodes on the inside of the arm band.
Through a patient’s smartphone, it generates electrical impulses, sending them to the brain to release the body’s own painkillers to the nerves.
Similar to a nicotine patch, you place the Nerivio Migra device on your arm above the elbow. The device communicates wirelessly via Bluetooth with your smartphone, which regulates the electrical pulses and sets a timer. A 45-minute treatment can bring relief for pain within two hours.

In tests, 66.7% of the 252 migraine sufferers in 13 clinics felt relief after 2 hours, compared to 28% of those using a placebo, or dummy device.

Call and speak to one our providers to learn more about this revolutionary device. We are one of the very few neurology practices providing demonstrations! We are very excited about Nerivio Migra and look forward to seeing you!

What is Trigeminal Neuralgia?

Trigeminal neuralgia is a chronic pain condition that affects the trigeminal nerve, also known as the 5th cranial nerve. The trigeminal nerve consists of three branches that conduct sensations to the brain from the upper, middle, and lower portions of the face, as well as the oral cavity. Trigeminal Neuralgia is caused by a variety of conditions resulting in pressure, compression or injury to the trigeminal nerve.
Typical presentation is characterized by an extreme, sudden burning, or shock-like facial pain, lasting seconds to two minutes per episode. These attacks can occur in quick succession. Atypical presentation is characterized by a more constant sensation of pain that tends to be slightly less severe than the typical presentation. Both typical and atypical presentation of pain may occur in the same person and potentially at the same time. The intensity of pain can be physically and mentally debilitating.
The intense flashes of pain can be triggered by contact, or even light touch. For example, daily activities such as shaving, washing the face, applying makeup, brushing teeth, eating, drinking, talking and even being exposed to the wind can trigger pain.
Treatment options include medicines, surgery, and alternative therapy. Come see us for an evaluation if you are experiencing any of these symptoms, we can find the right treatment for you!

Caroline Pruski, NP

TRACKING HEADACHES

Tracking headaches

Keeping track of your symptoms can be very helpful for several reasons. First, it is a tool to help your provider find the right treatment for you. Also, it is helpful for you to determine what is causing the headaches or migraines. By keeping track of activities, foods eaten, and stressors prior to getting the headache, it will make it easier to know what to avoid in the future.
For example, some people find that eating specific foods may trigger a migraine.

Additionally, some people find a pattern of headaches that may be associated with a certain time of the day or day of the week.

You may track your headaches using the calendar on your cell phone, a paper journal, or one of many headache tracking apps such as iHeadache.

For more information about tracking your headaches and using the information you recorded to guide your care, call The Manhattan Center for Headache & Neurology. We look forward to seeing you!

By: Brooke Steiger, NP

Migraine and Pregnancy


Migraine is especially common in women of reproductive age. There are many treatments available for migraine that are highly effective but common questions I get from patients who fall into this population include:
What am I going to do when I am trying to get pregnant, am pregnant, or breast feeding?
Will I have to stop my current treatment that has been working so well?
What are the fertility risks associated with migraine treatment during this time?

Don’t worry, we will find an individualized treatment plan for you! Another reason not to worry is the fact that for most women, pregnancy and breast feeding after pregnancy is protective against migraine. Approximately 47% of women have improvement in their migraines during their 1st trimester, 83% during their 2nd trimester and 87% during their 3rd trimester. Essentially for most women, the rate of remission from migraines increases as the pregnancy progresses.

Even if your migraines don’t improve during your pregnancy there are still options for you, such as:
Non-pharmacological behavioral changes and approaches can help decrease the frequency and severity of migraines. For example: rest and relaxation techniques, biofeedback, behavioral sleep modification, prenatal yoga.
Supplements and minerals are safe during pregnancy and are shown to improve migraine. Supplements include: Riboflavin, Vit B2, CoQ10, and Magnesium.
Acetaminophen (Tylenol) is safe to use in all trimesters as an abortive while pregnant
Metoclopramide (also known as Reglan) is an ant-nausea medication that is safe during all trimesters, can help with the nausea associated with migraines and the nausea associated with pregnancy (hyperemesis gravidarum)
Occipital and trigeminal peripheral nerve blocks (preferably done with just lidocaine) can be given when pregnant
Neuromodulation devices

By: Caroline Pruski, NP