NJNI:
Headaches Don't Have To Be "Tolerated"
EDISON, NJ—Philip A. Hanna, M.D., a neurologist and Associate Professor of Neuroscience at The New Jersey Neuroscience Institute (NJNI) at JFK Medical Center in Edison comments, “Headaches are one of the symptoms that people often feel they must tolerate. They assume there's little one can do but take two aspirin, lie down and wait for it to pass. And if they suffer from it chronically, they believe they must accept their fate. That's simply not true. In fact there are certain treatments that are changing the way patients manage chronic headaches.”
Dr. Hanna is at the forefront of those using botulinum toxin (also known as BTX and marketed as BOTOX ® ) for a variety of neurological conditions, including headaches.
“The muscles of the head and the blood vessels found along the surface and at the base of the brain are sensitive to pain because they contain delicate nerve fibers. The ends of these pain-sensitive nerves, called nociceptors, can be stimulated by stress, muscular tension, dilated blood vessels, and other headache triggers,” says Hanna. There are a number of different kinds of headaches, from cluster headaches to migraines, all of which have differing causes. Migraines, for example, are a kind of vascular headache, and are thought to involve abnormal function of the brain's blood vessels or vascular system; muscle contraction headaches appear to involve the tightening or tensing of facial and neck muscles due to such things as stress; and traction and inflammatory headaches are symptoms of other disorders, ranging from brain tumor to stroke to sinus infection.
Some headaches are signals of more serious disorders, some are more innocuous and result simply from missed meals or occasional muscle tension. A doctor can evaluate whether a headache is an indicator of something more serious. Many are easily remedied with stress reduction, elimination of certain foods in the diet, regular exercise, cold packs, or drug therapy. About 90 percent of chronic headache patients can be helped with any of these treatments. But when a patient's frequent headaches are not relieved by standard treatments, there are alternatives, including the use of botumlinum toxin.
Dr Hanna explains, “Botulinum toxin is a protein which acts at nerve endings within muscles. By impairing the transmission of signals between the nerve and muscle, it results in a weakness of the injected muscle or muscle groups, thereby temporarily reducing the excess muscle contractions involved in various movement disorders.”
For those who suffer from chronic headaches, the result is a welcome respite. The injections provide much needed relief, enabling them to have a much better quality of life particularly due to improved daily functioning.
Side effects to BTX are usually limited to the injected site, though patients may experience a transient mild general malaise. Additional side effects (relative to the area of injection) may prove problematic (such as swelling, blurred vision, problems with swallowing or speech) but are rare, almost never disabling, and usually resolve within days or weeks. Additionally, patients should note that some health insurance carriers do not yet cover BTX treatments.
It usually takes three to seven days for patients to notice improvement. The results last for three to six months until re-injection is necessary. Unfortunately, however, a small percentage of patients lose their response to the injections because their bodies develop an antibody to the toxin. There are additional strains of the toxin available, which offer those who develop a resistance additional treatment options.
The New Jersey Neuroscience Institute at JFK Medical Center is a comprehensive facility designed exclusively for the diagnosis, treatment, and research of complex neurological and neurosurgical disorders in adults and children. Services offered at the Institute include programs in minimally-invasive and reconstructive spine surgery, peripheral nerve surgery, brain tumors, dizziness and balance disorders, epilepsy, sleep, memory problems/dementia, cerebral palsy, stroke, and spasticity and movement disorders. As a department of Seton Hall University 's School of Graduate Medical Education , NJNI serves as the clinical setting for SHU's residency training in neurology. For more information on the New Jersey Neuroscience Institute, call 732-321-7950 or visit the facility online at www.njneuro.org .