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Migraine Etiology Hypothesis

"Menstrual Migraine" reduction with the NTI-tss

Recently, a dentist contacted NTI-TSS Inc. with the following question:

I heard about the NTI treatment therapy from an article in USA Weekend.  I have a patient who suffers from migraines, but only when she is having her monthly period.  She is 40 years old and every month she suffers 2-3 days from migraines.  

Does this treatment therapy work to treat migraines that may be hormonal in nature?  I do not believe she is a bruxer.

Thanks for your info.

NTI-TSS Inc. contacted Joyce Warwick, DMD, who is an experience NTI-tss provider and has been using the device to prevent her own migraine pain.  Dr. Warwick replied:

Hi Dr McCaskill,

Dr Boyd forwarded your question to me since I am a long time user of the NTI both professionally and personally. I am a dentist in Pittsburgh, Pa and have been using the NTI for 2.5 years with great success. I got interested in the device since I suffered from daily tension headaches and migraines averaging 2 per month and always with my period. I was skeptical that an anti-clenching device could have any effect on what I perceived to be migraines with a hormonal trigger. 

I am happy to report that the NTI has greatly decreased my own migraines, including those associated with my period. Prior to NTI use I had suffered that period migraine monthly without fail for over 12 years. (I know they began after the birth of my first child.) After wearing the NTI for 3 months I didn't get that period migraine for the first time in 12 years. Now that I have worn it for about 2 years, my migraines have decreased from 24/year to 3/year. It appears that the longer I wear it, the more infrequent my migraines become.  (Tension headaches were totally gone after one week of NTI use.)

My experience with patients has also been very good as well. I have one woman patient who had a similar history to mine who has not had a migraine in about 6 months now. I have not had a headache patient who has not felt a significant benefit from wearing the NTI.

If you study Dr Boyd's web site you will see that in medicine there is a lot of speculation and little fact about what really causes migraines. Clenching appears to be at least one of the triggers and by wearing the NTI and reducing the tension in the spindle fibers of the musculature, you are raising the threshold for what will trigger a migraine event. Now that I am wearing the NTI for so long, I find that things that used to trigger a migraine like certain smells and red wine are much better tolerated. I hypothesize that I can now also better tolerate the hormonal bombardment around my period since the musculature is relaxed and not primed for spasm.

You commented that your patient is not believed to be a bruxer. It is true that many migraineurs are not bruxers. They are static clenchers instead. Their teeth will not show the occlusal wear patterns characteristic of bruxers, but may show abfractions and enamel crazing. They clench in centric or in an excursion rather than grind back and forth.  This was really a key concept for me in understanding why horseshoe shaped occlusal guards were not really effective for all the
symptoms my patients presented with. They still allowed the patient to clench!

I encourage you to try it on this patient, but be aware that she might not get migraine relief for several weeks or months. Don't give up and feel free to email me for advice should you have any questions as her treatment progresses. Adding the NTI to your practice will be very rewarding.

Joyce Warwick, DMD

Dr. Warwick is also featured in the Pittsburgh Post-Gazette.

Although fluctuating hormone levels are not "painful", they can allow migraine events to be triggered more readily.  One of the major components which can also serve to increase the frequency of migraine episodes is pericranial muscular dysfunction (which can be "sub clinical", meaning it may not be normally symptomatic).  The spindle fibers which reside within this musculature are controlled by the sympathetic nervous system.

The SNS's tone is put "on alert" as hormone blood levels begin to fluctuate (which is normal).  This increase in sympathetic tone causes the intrafusal fibers within the spindles (which reside within the dysfunctional musculature) to tense, contort, or spasm, resulting in migraine pain. (Sympathetically Maintained Spindular Dysfunction:  A Hypothesis for the Etiology of Chronic Tension-type Headache and Migraine).


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