Acta Scientific Neurology (ASNE) (ISSN: 2582-1121)

Case Report Volume 4 Issue 8

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.

Received: June 28, 2021; Published: July 29, 2021

Abstract

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

References

  1. “Headache Classification Committee of the International Headache Society (IHS). The International Classification of Headache Disorders, 3rd edition”. Cephalalgia 38 (2018): 1-211.
  2. Parikh SK and Young WB. “Migraine: stigma in society”. Current Pain and Headache Reports 23 (2019): 8.
  3. “Global, regional, and national incidence, prevalence, and years lived with disability for 328 diseases and injuries for 195 countries, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016”. GBD 2016 Disease and Injury Incidence and Prevalence Collaborators. Lancet 390 (2017): 1211--1259.
  4. Steiner TJ., et al. “Migraine is first cause of disability in under 50s: will health politicians now take notice?” Journal of Headache Pain 19 (2018): 17.
  5. Gupta VK. “Pathophysiology of migraine: an increasingly complex narrative to 2020”. Future Neurology 14 (2019): 2.
  6. Gupta VK. “Migrainous scintillating scotoma and headache is ocular in origin: A new hypothesis”. Medical Hypotheses 66 (2006): 454-460.
  7. Ashina M., et al. “Migraine and the trigeminovascular system--40 years and counting”. Lancet Neurology 18 (2019): 795-804.
  8. Goadsby PJ., et al. “Pathophysiology of migraine: a disorder of sensory processing”. Physiology Review 97 (2017): 533-622.
  9. May A and Burstein R. “Hypothalamic regulation of headache and migraine”. Cephalalgia 39 (2019): 1710-1719.
  10. Gupta VK. “CSD, BBB and MMP-9 elevations: animal experiments versus clinical phenomena in migraine”. Expert Review of Neurotherapeutics 9 (2009): 1595-1614.
  11. Gupta VK. “Reader response: Facial presentations of migraine, TACs, and other paroxysmal facial pain syndromes”. Neurology (2019).
  12. Gupta VK. “Nitric oxide and migraine: another systemic influence postulated to explain a lateralizing disorder”. European Journal of Neurology 3 (1996): 172-173.
  13. Gupta VK. “Laws that govern migraine research and the trigeminovascular system over forty years: the obvious, the irrelevant, and the outdated”. Pre-print (2019).
  14. Peatfield RC and Rose FC. “Migrainous visual symptoms in a woman without eyes”. Archives of Neurology 38 (1981): 466.
  15. Nicolodi M., et al. “Phantom eye: features and prevalence. The predisposing role of headache”. Cephalalgia 17 (1997): 501-504.
  16. Sorös P., et al. “Phantom eye syndrome. Its prevalence, phenomenology, and putative mechanisms”. Neurology 60 (2003): 1542-1543.
  17. Noseda R., et al. “A neural mechanism for exacerbation of headache by light”. Nature Neuroscience 13 (2010): 239-245.
  18. Silva GCC., et al. “Aura-like features and photophobia in sightless migraine patients”. Arquivos de Neuro-Psiquiatria 72 (2014): 949-963.
  19. Drummond PD. “Carotid artery compression”. Lancet 358 (2001): 1223.
  20. Yamada SM., et al. “A migraine-like headache induced by carotid- cavernous fistula”. Headache 47 (2007): 289-293.
  21. Zanchin G., et al. “Self- administered pain-relieving manoeuvres in primary headaches”. Cephalalgia 21 (2001): 718-726.
  22. Sprouse-Blum AS., et al. “Randomized controlled trial: targeted neck cooling in the treatment of the migraine patient”. Hawaiʻi Journal of Health and Social Welfare 72 (2013): 237-241.
  23. Gupta VK. “Is benign cough headache caused by intraocular haemodynamic aberration?” Medical Hypotheses 62 (2004): 45-48.
  24. Gupta VK. “Ocular compression maneuver aborts benign cough-induced headache”. Headache 45 (2005): 612-614.
  25. Gupta V. “Constipation-related migraine is linked to the effect of the Valsalva maneuver on the eye: A case report and a mechanistic review”. Webmed Central NEUROLOGY12 (2010): WMC001433.
  26. Reiner A., et al. “Neural control of choroidal blood flow”. Progress in Retinal and Eye Research 64 (2018): 96-130.
  27. McDougal DH and Gamlin PD. “Autonomic control of the eye”. Comprehensive Physiology 5 (2015): 439-473.
  28. Wei X., et al. “Assessment of flow dynamics in retinal and choroidal microcirculation”. Service Ophthalmology 63 (2018): 646-664.
  29. Gupta VK. “Systemic hypertension, headache, and ocular hemodynamics: a new hypothesis”. Medscape General Medicine 3 (2006): 63.
  30. Braakman ST., et al. “Transport across Schlemm’s canal endothelium and the blood aqueous barrier”. Experimental Eye Research 146 (2016): 17-21.
  31. Korenfeld MS and Dueker DK. “Review of external ocular compression: clinical applications of the ocular pressure estimator”. Clinical Ophthalmology 10 (2016): 343-357.
  32. Arnold RW. “The oculocardiac reflex: A review”. Clinical Ophthalmology 15 (2021): 2693-2725.
  33. Huang J-Y., et al. “Migraine and increased risk of developing open angle glaucoma: A population-based cohort study”. BMC Ophthalmology1 (2019): 50.
  34. Gramer G., et al. “Migraine and vasospasm in glaucoma: Age- related evaluation of 2027 patients with glaucoma or ocular hypertension”. Investigative Ophthalmology and Visual Science 13 (2015): 7999-8007.
  35. Xu C., et al. “Migraine as a risk factor for primary open angle glaucoma: A systematic review and meta-analysis”. Medicine 28 (2018): e11377.
  36. Phelps CD and Corbett JJ. “Migraine and low-tension glaucoma. A case-control study”. Investigative Ophthalmology and Visual Science 26 (1985): 1105-1108.
  37. Gupta VK. “Visual function impairment in migraine: cerebral versus retinal deficit”. Cephalalgia 13 (1993): 431-432.
  38. Gupta VK. “Pupillary disturbances in migraine: what is the relation to autonomic dysfunction?” Journal of Neurology, Neurosurgery, and Psychiatry 54 (1991): 847-848.
  39. Gupta VK. “Disfunzioni visive nell’emicrania: possibile influenza della pressione intraoculare (Visual function dysfunction in migraine: possible link to intraocular pressure)”. Confinia Cephalalgica 1 (1992): 259-261.

Citation

Citation: Vinod Kumar Gupta. “Self-Ocular Compression Maneuver Immediately Relieves Migraine Headache Attacks: Case Report of Managing 100 Attacks Over 9 Years and a Mechanistic Review". Acta Scientific Neurology 4.8 (2021): 72-77.

Copyright

Copyright: © 2021 Vinod Kumar Gupta. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.




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