" Migraine pathophysiology is complex and there has been a long debate if it is central or periheral in orgin as well as whether it is primarily neurogenic or vascular. Chakravarty A, Sen A. in their article state that "We argue on the validity of the prevailing concept that maintenance of structural integrity of the nervous system differentiates nociceptive pain from neuropathic pain and point out that the fundamental pathophysiology of lasting nociceptive pain (like cancer pain) and neuropathic pain (like nerve injury pain) is essentially same."
This is supported by what is found in Neuromuscular Dental treatment of headaches and TMJ disorders. The peripheral input affects the central nervous system primarily thru the Trigeminal Nerve creating central sensitization and chronic migraine pain. The basic premise of Neuromuscular Dentistry is that reducing the nociceptive input reduces central pain mediation at the trigeminal ganglion. Many of the chemical inbalances that lead to migraine are secondary to noxious neural input or nociception.
The authors state "t the end, we suggest that fundamentally all the three pain syndromes referred to in the article share a common pathophysiological mechanism, namely peripheral pain perception, peripheral sensitization at dorsal root ganglion or its intracranial counterpart (like trigeminal ganglion) and central sensitization at the spinal cord (dorsal horn for somatic pain), brain stem nuclei and thalamus before final pain perception at the sensory cortical matrix. " If the underlying pathophysiological mechanism from peripheral nociception is turned off the central sensitivazion can be reduced or eliminated.
I HATE HEADACHES LLC has recently released www.ihateheadaches.org to help migraine and headache sufferers find effective treatment protocols. The concepts presented in this article support the information at the headache site.
Dr Ira Shapira recently rleased an easily understood explanation of neuralmuscular dental concepts in Sleep and Health Journa. The article can be found at: http://www.sleepandhealth.com/
Dr Shapira describes this central sensitazion as "The second type of problems would be described as I/O or Input/ output errors in computer lingo. The CNS is essentially a biological computer and is affected by input from afferent nerves from the body. Autonomic system function include the fight or flight response with concomitant release of adrenaline that alters the heart rate, blood pressure, muscle tone etc. " If one considers the the brain as a computer than excessive nociceptive input alters both the software (ie patient perception )
and the hardware or neural synapses altering neurotransmitter chemical actions within the brain.
Neurologists and Pain Specialists have recognized that Botox injections at the neuro-motor junction of trigeminally innervated temporalis and masseter muscles can relieve even severe migraines for a period of weeks. Neuromuscular Dentistry replaces this crude method by restoring the health of the trigeminal neuromuscular complex to decrease nociceptive input and central sensitivation. The vascular components of migraine are also trigeminally modulated as the V nerve controls blood flow to the anterior two thirds f the mininges of the brain.
Patients seeking long term drug free treatment and/or elimination of Migraine, Chronic Daily and TensionType headaches should investigate the www.ihateheadaches.org website. Patients in the Chicago and Milwaukee areas can contact Dr Shapira for Neuromuscular Dental evaluation and treatment at 1-800-TM-JOINT or thru the I HATE HEADACHES site which he founded.
