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Experimental treatment brings migraine relief without medication

A treatment for post-traumatic stress disorder has recently gained attention for its potential to treat and prevent migraines. Eye movement desensitization and reprocessing (EMDR) is used by therapists to help patients process traumatic memories and experiences.

Los Altos psychotherapist Steven Marcus has applied his knowledge of EMDR, on which he has published several papers, to experimental treatment for migraines. It combines three forms of physical intervention to treat and prevent migraine pain without drugs.

"Medications work great for some people, but lots of people can't tolerate them," Marcus said. "Medication won't eliminate pain, but it controls it."

Migraines, in which blood vessels in the brain become inflamed and cause crippling pain and other symptoms, have been linked to such triggers as stress, lack of sleep, diet and genetics.

Between 40 million and 50 million people in the United States have chronic recurring headaches, and that costs businesses up to $15 billion a year in lost productivity. An industry has built up around treating headaches, particularly pharmaceuticals.

Conventional psychotherapy has demonstrated success in headache intervention, Marcus said, and biofeedback and relaxation training has been shown to be roughly equivalent to medication in headache prevention.

Experimental data suggest that external stimulus, such as tracking a moving object with one's eyes, can assist a patient's brain in adapting to trauma or to a headache's pain signals.

"The bilateral eye movements (of EMDR) send a message to the brain stem to relax, and the parasympathetic nervous system ignites a relaxation response," Marcus said. While he thinks most migraines have multiple triggers, he said, "People develop anxiety around a migraine - the number one patient reported cause of headache is stress."

The brainstem serves as the nerve locus that sends migraine signals to the rest of the brain. A patient with an active migraine would focus her eyes on a practitioner's moving fingers while focusing her mind on the location of her pain. EMDR protocols work both to stop the pain and to prevent its recurrence by helping the brain unlearn the triggers that cause headache.

Marcus has found the EMDR treatment most effective when combined with two other therapeutic methods, breathing and head compression. Diaphragmatic breathing is the kind of deep, calming breathing practiced in meditation or yoga.

In head compression, a practitioner like Marcus slowly presses on the patient's head, from the front and the back, and then the sides. The sensation and its effects might seem familiar to migraine sufferers who have squeezed a pillow to their head for some relief. Marcus said that, in fact, he discovered the treatment from anecdotal evidence from migraine patients.

"Each treatment on its own captures some pain, but the success rate is not very high," Marcus said. He said that when combined, they have a success rate of 80 percent to 90 percent for resolving active migraines.

Marcus has been training other professionals to administer this migraine treatment, and intends to continue his research. In the future, he hopes that the treatment could be learned by family members of a migraine sufferer, so that relief could be had without a visit to a doctor's office.

For more information, call Marcus at 962-1987. To learn more about EMDR, visit www.emdrinstitute.com.

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