Self-Ocular Compression Maneuver Immediately Relieves Migraine Headache Attacks: Case Report of Managing 100 Attacks Over 9 Years and a Mechanistic Review
Vinod Kumar Gupta*
Physician-Director, Migraine-Headache Institute, New Delhi, India
*Corresponding Author: Vinod Kumar Gupta, Physician-Director, Migraine-Headache Institute, New Delhi, India.
June 28, 2021; Published: July 29, 2021
The pathophysiologic basis of migraine is uncertain. Abortive management strategies for acute migraine attacks are, therefore, based on presumptive approaches. Widespread use of triptans or analgesics either alone or in combination with caffeine to abort episodic migraine headaches does not allow for precise knowledge of pharmacologic site or mechanism of action. Ocular compression maneuver (OCM) has been previously reported to manage primary cough headache by immediate reduction of Valsalva-induced corneoscleral envelope distention/undulation and nociceptive ocular ophthalmic (V1) trigeminal neural traffic activation. I report the successful and safe use of OCM induced painless self-ocular tamponade through closed eyelid(s) to abort recurrent episodic migraine headache attacks and post-coital headache attacks. The scientific basis for ocular origin of migraine headache has been previously elucidated. The mechanistic link between ocular autonomic nervous system (ANS) dysfunction, choroidal overperfusion/intraocular pressure (IOP) elevation, and nociceptive corneoscleral distention/undulation in migraine headache and primary headache with sex/post-coital headache (PCH), and, their abortive management with the self-OCM is presented for the first time in migraine literature.
Keywords: Migraine; Primary Headache Associated with Cough; Primary Headache Associated with Sex; Self-ocular Compression Maneuver; Ocular Tamponade; Choroidal Vascular Circulation; Intraocular Pressure; Ocular Autonomic Nervous System; Digital Ocular Massage
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