Dr. Shapira's Chicago Headache Blog
Neuromuscular Dentist in Chicago, IL Accepting Patients Nationwide & Worldwide
TRIGEMINAL AUTONOMIC CEPHALGIAS, Chronic Headaches Related To Trigeminal Nerve Respond well to Neuromuscular Dentistry & Sphenopalatine Ganglion Block
The Trigeminal Nerve is often called the Dentist's Nerve because it goes to the teeth, jaw muscles, jaw joints (TMJ),and periodontal ligament. Trigeminal innervation of the sinuses, eustacian tubes, tensor of the ear drum (tensor tympani), soft palate, tongue and meninges of the brain explain why there are so many disorders associated with jaw function, TMJ and TMD.
There are a special group of disorders called the Trigeminal Autonomic Cephalgias (See National Institute of Neurological Disorders and Stroke web information below). Sphenopalatine Ganglion Blocks are an autonomic block that can be used to treat many types of migraine, Tension-tyoe headaches and chronic daily… Read Full Post
Facial Pain, Normal Sinus CT scans, Headache, Migraine and TMD
An older study in the Laryngescope is on 104 patients with facial pain who had normal CT scans. Twenty nine of the patients had previous unsuccessful sinus surgery. The patients were approximately 80% women, TMJ disorders are usually (80%) found in female patients.
The study showed " Four percent of patients seen by a neurologist had an unsuspected serious intracranial diagnosis." It is essential that organic neurologic causes are ruled out but the 100 remaining patients had headaches of undetermined causes. Facial pain and sinus pain are a alert for MPD (myofascial pain) and TMD (temporomandibular pain). Treatment of patients with chronic headaches, migraines sinus and/or facial… Read Full Post
Headaches and TMJ Disorders are related to whole body health.
A new article in Practical Pain Management "Head and Neck: Kinetic Chain from the Toes Influences the Craniofacial Region " discusses the kinetic chain and how what happens in the body effects the craniofacial region and how jaw problems, bite stability and joint stability influences the entire body as well. These postural changes are a major cause of Tension-type headaches, neck pain and other types of myalgias.
The field of Posturology is how our posture affects the entire body. Posture includes how we stand, sit, lay down, sleep, work out and more. If we overwork muscles we can cause repetitive strain injuries that lead to myofascial pain and dysfunction.
There are… Read Full Post
Frontal and Occipital Headaches with Facial Numbness
From Vicki:
I have right sided pain in the occipital region and frontal area. Continuous pulsation with buzzing in my ear. I am Nauseated, and have right sided facial numbness and tingling.
Dr Shapira response:
I always suggest patients with numbness in the face have a neurological work-up and patients with ear problems be evaluated by an ENT. Having said that I frequently see patients with symptoms similar to your who are very successfully treated by their diagnostic neuromuscular orthotic without drugs.
The occipital pain is usually referred from neck muscle trigger points, especially from the SCM, Trapezius,
Levator Scapulae,,splenius capitus and… Read Full Post
VESTIBULAR MIGRAINE; THE SIGNS AND SYMPTOMS HAVE LARGE OVERLAP TO TMJ (TMD). ARE VESTIBULAR MIGRAINES BEST TREATED BY NEUROMUSCULAL DENTAL ORTHOTIC
A recent article in HEADACHE (June 2011)"Migraine and Vestibular Symptoms-Identifying Clinical Features That Predict "Vestibular Migraine" looks at patients who have an overlap of vestibular symptoms, such as lightheadedness, unsteadiness, vertigo, balance disturbance and headache.
The study showed just under half of the patients had onset of pain and vestibular symptoms together. This is frequently seen in patients withcraniomandibular neuromuscular disorders and usually responds extremely well to a neuromuscular orthotic, use of ULF TENS, Trigger point injections, spray and stretch elimination of TP's and SPG (Sphenopalatine Ganglion) Blocks.
NEUROMUSCULAR DENTISTRY… Read Full Post
New Developments in Migraine Treatment and how they relate to Neuromuscular Dentistry and Posturology
A recent article in Current Opinions in Neurology reviewed Migraine treatments. While it mentioned the use of medications such as Botox (onabotulinum toxin type A), triptans , Topiramate, gabapentin, petasites and tizanidine and a new nasal form of dihydroergotamine it also discussed risk factors associated with Temporo-mandibular (TMJ, TMD) disorders, sleep apnea and treatments like occipital nerve stimulators.
These are important aspects of Neuromuscular Dentistry which utilizes ultra-low frequency TENS to stimulate the Cranial Nerves V, VII and XI. This would create effects on occipital nerves as well. The use of Botox on cranial muscles shows that they are responsible for… Read Full Post
Retro-orbital pain and TMD (TMJ) explained anatomically in this article.
A mechanism for retro-orbital pain and TMD is presented in this anatomical dissection of the the temporal branch of the zygomatic nerve passing through an accessory canal in the sphenozygomatic suture. This anatomical placement of the nerve would allow temporal muscle tension to cause nerve irritation and retro-orbital pain. Utilization of a diagnostic neuromuscular orthotic could differentiate retro-orbital pain that is best treated by neuromuscular dentistry.
Surg Radiol Anat. 2002 May;24(2):113-6. Nervous branch passing through an accessory canal in the sphenozygomatic suture: the temporal branch of the zygomatic nerve. Akita K, Shimokawa T, Tsunoda A, Sato T.
Unit of… Read Full Post
Headaches related to rectus capitis posterior minor muscle and its atlanto-occipital membranes
A recent post of mine discussed the relationship between osteopathic (chiropractic) manipulation and TMD. That study showed that similar results were obtained with both types of treatment. A major consideration in treating headaches is the position of the head and neck. Neuromuscular dentistry tends to encourage healing or correction of abnormal head posture. This can have an enormous effect of the jaw muscles and jaw joints but also on the Atla-occipital joint and the Atlas-axis joint and surrounding tissues. These tissues (such as rectus capitus posterior minor) can create tension on the dura mater of the brain that can cause not just migraines, tension-type headaches, chronic daily… Read Full Post
Throat Pain: Frequently can be hard to diagnose and misdiagnosis is common.
An article (PubMed abstract below) in Janury "CRANIO journal" by Dr Wes Shankland dicusses patients with anterior throat pain. These patients have frequently seen numerous physicians and had multiple digagnostic tests and frequently ineffective treatment. There are five syndromes that frequently cause this type of problems. The five disorders are, Ernest syndrome, Eagle's syndrome, carotid artery syndrome, hyoid bone syndrome and superior pharyngeal constrictor syndrome.
Ernest syndrome and Ernst Syndrome are caused by calcification of stylohyoid or stylomandibular ligaments that is frequently diagnosed by panoramic radiographs and palpation of the ligaments. There are… Read Full Post
Temporal Tendinitis: A Migraine Mimic Temporal Tendinitis is a very common disorder frequently misdiagnosed and/or mistaken for migraine.
There was an excellent article in Practical Pain Management by Edwin A Ernst III DMD on Temporal Tendinitis. Common pain reference sites (according to the article) for this condition include: Painful TM Joints (Temporomandibular joint or TMJ), Ear Pain and/or stuffiness in the ear, retro-orbital pain sometimes radiating to occiput and /or shoulder, upper and lower aching teeth, pain in or around the eye, pain in the lateral temple area, and occasionally pain in the area of the stylomandibular ligament. These pains are frequently accompanied by prodromal symptoms similar to migraine of Nausea, vomiting, photophobia and visual disturbances.
This can be extremely intense pain and is… Read Full Post