Headache Symposium

	HEADACHE SYMPOSIUM	Edward Lichten, M.D.,PC 180 East Brown Street Birmingham, MI 48009 248.593.9999
New Advances in Headache Management by Seymour Diamond, M.D. Emergency Treatment of Migraine by Merle Diamond, M.D. Biofeedback by Seymour Diamond, M.D. The Headache Questionnaire Hormonal Migraines by Edward Lichten, M.D. Understanding Trigger Point Therapy Occipital Neuralgia by Christopher R. Brown, D.D.S Cervicogenic Headache by Dennis Dobritt, D.O. Physical Therapy & the Cervicogenic Headache by Paul Roubal, Ph.D., P.T. The Osteopathic Approach to Cervicogenic Headache by Mitchell Elkiss, D.O. Analgesic Rebound Headache by Edward Lichten, M.D. Treatment of Headache in Norway and Sweden In an effort to promote a clearer understanding of the patho-physiology of headache, migraine and occipital neuralgia, Lichten and associates organized a national symposium in 1994 that brought together many of the leaders in headache practice and research. The articles from the meeting have been transcribed and are available at no charge. Should you have questions about anything you read, please feel free to contact me at 248.593.9999. Most sincerely, Edward M. Lichten, M.D. FACS, FACOG		Lichten's Pearls There are multiple levels of cervical root involved in chronic headache. 1. Occipital nerve C2-3 2. C-6 3. Subscapularis Treatment plan 1. Inject 3cc of 1% lidocaine with 1/2cc of dexamethasone at C2-3 notch (1 inch lateral to midline) 2. Palpate the C5-6 lateral vertebrae for triggers. Usual location is directly lateral. Inject 1cc here. 3. Palpate the supra-spinatus (trapezoid between neck and acromion (shoulder) for tightness. One inch from plum line of ear is the scapular notch. Tenderness there shows the subscapularis muscles to be in spasm and fixing the scapula-shoulder complex from moving. Injections into the subscapulais may be needed to resolve the pain issues.