Resolution of Migraine Headaches Following Multimodal Neurorehabilitation
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1
Bagnell Brain Center, United States
Background: A 53-year-old female presented to a chiropractic functional neurology clinic complaining of migraine headache, mental fog, and insomnia. Self graded assessment of brain functionality revealed sensitivity to light and sound, emotionality, and feeling unsteady.
Methods: Neurological testing was performed which included Biodex Biosway Clinical Test of Sensory Integration & Balance (CTSIB) on perturbed and non-perturbed surfaces and saccadometer testing. Clinical Test of Sensory Organization and Balance (CTSIB) evaluation on Biodex Biosway revealed sway indexes 2 standard deviations below normal for age and height matched on a normative database. Finger to thumb tapping was graded at +2 on the right; gait analysis revealed decreased left arm swing.
Treatment consisted of Interactive Metronome (IM) training for 10 sessions, 12-18 minutes in length over a 5-week period. These twice-weekly sessions consisted of hand clapping to metronome activity and standing or seated stepping with both feet to metronome activity at 54 beats per minute (BPM). The participant performed these tasks over increased time intervals beginning at 2.6 minutes per session and reaching a maximum of 18 minutes. Patient specific treatment consisted of right brain exercises and repetitive Peripheral Somatosensory Stimulation (rPSS) that was applied to the right mandibular and ophthalmic branches of the trigeminal nerve. Neurofeedback was also performed during each visit using BrainMaster 24 channel EEG. At the end of the 5-week period, the patient returned to retest the CTSIB and the saccadometer.
Results: Saccadometer testing initially revealed bilateral hypometria. Post treatment saccadometer testing demonstrated a significantly more metric phase plot. CTSIB post testing on perturbed surface, with eyes open showed an average improvement of 23%. CTSIB post testing on non-perturbed surface with eyes open showed an improvement of 20.5% and with eyes closed improvement was 27%. Interactive Metronome Session Highest Super Right On % (SRO%) increased from 16% to 43%.
Conclusion: The patient showed an improvement of results in all of the post testing after the five-week period of IM treatment. However, there was a difference in the percentage of improvement between eyes open and closed on the CTSIB. Significantly more improvement was realized with eyes closed. The current case demonstrates that Interactive Metronome along with Neurofeedback and brain specific neurorehabilitative exercises might be utilized as an effective tool for migraine patients. Future research should be conducted in this area.
Keywords:
Migraine,
Neurorehabilitation,
Neurology,
Headache,
Neuroscience
Conference:
International Symposium on Clinical Neuroscience 2018, Orlando, Florida, United States, 24 May - 26 May, 2018.
Presentation Type:
Poster
Topic:
Clinical Applications in health, disease, and injury to the nervous system
Citation:
Irons
H,
Bagnell
MK and
Schmidt
M
(2018). Resolution of Migraine Headaches Following Multimodal Neurorehabilitation.
Front. Neurol.
Conference Abstract:
International Symposium on Clinical Neuroscience 2018.
doi: 10.3389/conf.fneur.2018.60.00035
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Received:
23 Oct 2017;
Published Online:
14 Dec 2018.
*
Correspondence:
Ms. Hannah Irons, Bagnell Brain Center, Miami, United States, hirons131@gmail.com
Dr. Michael K Bagnell, Bagnell Brain Center, Miami, United States, bagnelldc@gmail.com