Either way, our job is twofold:
- We must figure out WHY you are getting these migraines
- Based on the cause, we have to develop a treatment plan based on the 4 Pillars.
Most docs are not looking beyond an MRI for the cause. If you don’t have a tumor, you start on the medication cycle to reduce the pain. It is difficult if not impossible to put out a fire by throwing buckets of water on it when someone on the other side is throwing gasoline on it!
Have you been suffering from migraines?
Step 1: Evaluation/Examination
By the time they get to me, most patients have had an MRI of their brain. We know that there is not usually a structural cause of the pain. What we need to do is functional testing.
Since migraines are a problem with the Trigeminovascular system in the brainstem, we need to find out why that area is dysfunctional.
The examination will include a complete physical exam and extensive functional neurological exam. Eye movements as well as balance systems are also located in the same region in the brainstem, so evaluating these gives us amazing insight into migraines.