new program at the University of Cincinnati (UC) Neuroscience Institute
promises a personalized approach to pain for the thousands of people in the
Cincinnati region and beyond who suffer from migraines, cluster headaches and
Headache and Facial Pain Program, which opened this week, will call upon
specialists from multiple disciplines to help patients reduce or eliminate the
pain that is unique to them.
program is one of the only multidisciplinary headache and pain centers in our
region,” says Vincent Martin, MD, a UC Health headache specialist, professor of
medicine in the UC College of Medicine and co-director of the program.
the past, headache and facial pain have been treated separately and without
much integration. This is the first program regionally to combine services that
include neurology, internal medicine, neurosurgery, neuro-oncology,
otolaryngology (ear, nose and throat), oral surgery and integrative medicine to
maximize the treatment of both headache and facial pain.”
program is the newest addition to the UC Neuroscience Institute, one of four
institutes of the UC College of Medicine and UC Health. Co-director of the
program’s facial pain component is Ellen Air, MD, PhD, an assistant professor
of neurosurgery who also sees patients at UCNI’s Epilepsy Center and the James
J. and Joan A. Gardner Family Center for Parkinson’s Disease and Movement
facial pain and headache are frequently distinct, they also can be present
simultaneously, Martin says. "Facial pain is more in the cheekbones, jaw or in
the nasal region, while headaches are in the forehead, top of the head, sides
of head and back. These disorders tend to overlap. We know that patients with
headache can have facial pain and vice versa.”
who call to make an appointment will be referred to the most appropriate specialist
within the program. For example, a patient with temporomandibular joint
disorder, or TMD, may receive treatment from an oral surgeon who is an expert
in that field, while a patient with sinus infections that produce headache or
facial pain will be treated by an ear, nose and throat specialist.
subset of patients with facial pain who suffer from trigeminal neuralgia will
be referred to a neurosurgeon. Trigeminal neuralgia, which affects one in every
25,000 people, is an often misdiagnosed condition that has been described as
the "suicide disease.” Also known as tic douloureux, it occurs when the
trigeminal nerve is compressed by an artery, vein or tumor. The resulting
inflammation causes extreme pain and muscle spasms in the face.
Tew Jr., MD, a neurosurgeon with the Headache and Facial Pain Program and professor
of neurosurgery, surgery and radiology, has described the pain of trigeminal
neuralgia as being akin to "biting down on a red-hot poker.” Patients with trigeminal neuralgia typically
experience life-changing relief after surgical treatment, which is tailored to
the individual patient.
Air: "Trigeminal neuralgia is one of several types of facial pain that our team
of experts is uniquely positioned to effectively diagnose and treat.”
and other headache specialists will see many of the patients who suffer from
painful and disabling headaches, including migraines. About 16 percent of women
and 5 percent of men suffer from migraine headaches, Martin says. About three
to seven individuals per 100,000 experience cluster headaches, a rare and even
more severe disorder.
by their nature, are more likely to be tamed than cured.
headache is a disease of the nervous system, there’s not a cure,” Martin says.
"What you can do is dramatically reduce the frequency, severity and disability
of the headaches and make them less impactful on life.
are rare instances where you can get rid of the headaches completely. But for
the most part our objective is to manage the disease effectively. We give our
patients the tools to cope with their condition so that they don’t miss work,
family functions or social events that they might miss if they were not
means not only finding the right medications but also prevention. Identifying
headache triggers that can be avoided is a primary aim.
by Martin and his team is shedding light on the intricacies of headache
triggers. "We are looking at how hormones trigger headache, how sinus disease
and allergies trigger headache,” Martin says. "We are investigating
hyperflexibility and headache, and we are studying how some diseases—asthma, rhinitis,
depression, anxiety—are interrelated with headache.”
and his team made international news earlier this year with groundbreaking
findings that lightning strikes may affect the onset of headache and migraines for
those who suffer from them regularly.
best news for patients who suffer debilitating headaches is that 90 to 95
percent can be helped through treatment and behavioral changes.
of the people I see have already been to many different doctors and are still
suffering,” Martin says. "It is important for people with headaches to know
that there is hope. And we believe that with our multidisciplinary approach to
the problem, we can offer treatments that others have not tried in the past.”