Faculty: Dr. Adam Harcourt
Migraine Neurophysiology & Clinical Manifestations
In order to effectively treat a migraine, you must understand how it neuro-physiology so you can then decide how to solve it for the patient.
- Societal impact – Costs and Epidemiology
- Clinical manifestations and progression
- Classification – Learn to recognize which type of migraine you are addressing.
- Pathophysiology – Get clarity around what aspect of their physiology needs addressing.
- Imaging – Learn the imaging you should order or need to interpret when managing the migraine patient.
- Trigeminovascular pain pathways – Get clarity on how the trigeminovascular system is involved in migraine.
- Brainstem and thalamic projections – Learn how the interplay between the brainstem and thalamus in the migraine case and what you can do about it.
- Brainstem modulation – Learn how to assess the brainstem and then perform clinical applications to improve its function.
- Hypothalamic modulation – What regulatory functions of the body need to be monitored with migraine and how do they effect your outcomes?
- Neurotransmitter systems – Learn which neurotransmitters are involved in the migraine patient and how it relates to treatment.
- Thalamic processing of trigeminovascular pain – Learn why is pain not limited to the trigeminal distribution of the face.
- Cortical processing – Learn what parts of the cortex are involved in migraine and how to assess them.
- Autonomic dysfunction – Address the discrepancies in the literature and how you can use this information to treat patients.
- Photophobia mechanisms – How does it occur and how can you help it?
- Aura & Cortical spreading depression – Are they the same? What does CSD have to do with migraine pathology?
- Genetics – Learn what factors predetermine your likelihood of migraine and how it causes different types of migraine.
Module 2 –
Migraine Building Blocks: Nutrition and Hormones
In order to effectively treat a migraine, you must understand how nutrition and hormones play a roll in the migraine condition, and how to solve those problems.
- Triggers and their role in migraine – Do triggers even exist? New research tells us why traditional wisdom may be a diversion from the actual cause.
- Nutrition & Migraine – Learn everything, including genetic components, of nutrition in migraine.
- Ketogenic, Atkins, Fasting, Vegan….what is the best diet for migraine??
- Omega 3’s and their effect on episodic migraine
- Caffeine – A harmful and helpful compound. How do we use it clinically
- B Vitamins – What are the vitamin correlates?
- Genetic base of nutrition, is there a method to the food sensitivity madness??
- Month by Month nutritional guidelines for successful migraine outcomes
- Antioxidants – Dealing with inflammatory aspects of migraine
- Sodium intake – How and when to use salt as an adjunct for treatment
- Vitamin D deficiency and migraine – What are the vitamin D correlates?
- Stress & Hormones – How does stress effect migraine? Find out how to test and interpret lab results and prescribe proper protocols.
- Menstrual related migraine – What can be done and why is it currently being done wrong
- Stress and migraine chronification – How to stop the downward spiral
- Estrogens role in migraine – Learn how the females hormones play a role in the migraine condition.
- Trigeminal alterations in menstrual migraine patients
- The effect of puberty on migraine
- Laboratory testing of stress hormones – Learn exactly what tests are worth ordering for stress hormones and which ones to skip.
- Interpretation and protocol development of HPA Axis dysfunction
Migraine Building Blocks: Musculoskeletal and Neurological
In order to effectively treat a migraine, you must understand how the musculoskeletal & nervous system play a roll in the migraine condition, and how to solve address those problems.
- Musculoskeletal components – Learn why manual therapies can be the best, or worst, treatment for migraineurs at different stages.
- Chiropractic – If and when joint manipulations would be appropriate.
- Massage – Why could massage be beneficial to the whole picture of migraine.
- Acupuncture – How does acupuncture act on the nervous system relating to migraine?
- Trigger Points – Is there a sensitization effect with migraine?
- TMS – Where and when could it be beneficial
- Surgical interventions – What types of surgical techniques are indicated for migraine, and how they can be used to manage patients long term.
- Migraine Variants – Learn how to properly treat the different types of migraine and what to look for that may have been missed.
- Vestibular – Commonly misdiagnosed, these patients suffer needlessly for years.
- Hemiplegic – Learn why clinical neuroscience is THE best treatment for this disorder
- Sleep related – Does timing of migraine change your treatment paradigm?
- Ocular – What to look for when treating these often frightening migraines.
- Neurological treatment modalities
- Which areas of the neuraxis should be examined closely
- What therapies/treatments are helpful for patients without overt functional deficits
- Concussion & Migraine – Learn how they relate and how to treat them together.
- How long after a concussion do you expect migraine to intensify
- Can concussion cause migraine by itself?
- Dizziness & Migraine – Learn why vertigo can actually be a migraine, and how to treat it properly.
Perfecting the Migraine Case
Putting it all together – This will occur throughout the 4-module series, and in this module you will learn all you need to know to effectively manage the migraine patient from patient history, intake and exits exams, in office rehab protocols and at home rehab strategies.
- Outcome measures – We will learn about current outcome measures and how to use them.
- Treatment modalities
- Medications – Learn how to manage patients and their medication with their prescribing physician. This is an art in itself!
- Botox – Pros and cons of use and how it relates to our migraine model.
- Cannabis – Learn how endocannabinoids work and why they may be a better option than many medications.
- Vestibular Rehab- Review vestibular function and how it relates to a migraine.
- Visual System Modalities – Learn a simple way to assess for dysfunction and prescribe treatments for acute and management care.
- Peripheral nerve stimulation – What it is, where, and when to use it
- Nutrition – How to coach migraine patients through the nutrition aspect, and the best way effective way to wean off of caffeine!
- Hormonal approach – We will run through many labs and interpret them so you are comfortable reading the first lab you order.
- Musculoskeletal – Learn when and where to apply manual therapies, and more importantly, when not to!
- Management of migraine patients – Training patients to understand their condition
- Live cases – Throughout the whole course we will encourage you to bring cases to help everyone’s learning process.