Case Study on FHM Hemiplegic Migraine Sufferer 28 May 23 July 2014 Organised by Tracey Kendall, Bowen Me

Transcription

1 Case Study on FHM Hemiplegic Migraine Sufferer 28 May 23 July 2014 Organised by Tracey Kendall, Bowen Me Aim To determine whether Bowen Therapy could reduce the frequency and duration of migraines therefore preventing a Hemiplegic Migraine from occurring. Candidate Male, age 53 Has been experiencing typical migraines since the age of 2. He grew out of them in his late 20s early 30s. Was diagnosed last year with a FHM hemiplegic migraine after being rushed to hospital with stroke-like symptoms paralysis down one side, nausea, blurred vision and speech. Grandmother, mother and daughter suffer(ed) migraines Background What is hemiplegic migraine? Hemiplegic migraine is referred to as a migraine variant. The word hemiplegic simply means paralysis on one side of the body. A person with hemiplegic migraine will experience a temporary weakness on one side of their body as part of their migraine attack. This can involve the face, arm or leg and be accompanied by numbness, or pins and needles. The person may experience speech difficulties, vision problems or confusion. This can be a frightening experience for the individual as these symptoms are similar to those of a stroke. This weakness may last from one hour to several days, but usually it goes within 24 hours. The head pain associated with migraine typically follows the weakness, but the headache may precede it or be absent. Familial Hemiplegic Migraine Familial hemiplegic migraine (FHM) is defined as migraine attacks occurring in two or more people in the same family who experience weakness on one side of the body as a symptom with their migraines. On average 50% of children who have a parent with hemiplegic migraine will develop this disorder. At least three different genes have been implicated in FHM. In half of the families where FHM occurs, a gene with a defect on chromosome 19 has been identified. This causes

2 the related calcium channel to work incorrectly from time to time, and when it does a series of biochemical changes result in a migraine attack. For other families chromosome 1 is implicated which alters the behaviour of a channel involved in cell energy and in still others a sodium channel gene on chromosome 2 is altered. Even these do not account for all cases so more genetic causes will be found during future research. Consultation: Can you identify migraine triggers what do you think they are? There are no specific triggers, there are certain things he does avoid in his diet like red wine and too much sugar but keeps his diet and the products he uses quite consistent. What is the process of a hemiplegic migraine? Starts with a cluster of typical migraines with the intensity building as time goes on. He may get a few days break between migraines whereas before (the hemiplegic migraines developed) it could be a month between typical migraines. A pain in his stomach which turns him inside out is also the first sign he is getting a hemiplegic migraine. What time of the day do you experience them? Generally morning or evening. Most cases he will wake up with a typical migraine or in the case of a hemiplegic migraine, the pain will wake him. How long do they last and what is the severity out of 1-10, 10 being the worst? The severity can get worse between each migraine but it also varies. Are there facts I should know that may not be found in hemiplegic articles? His paralysed state doesn t seem to last as long compared to other sufferers who are recording up to 3 days. His paralysed state comes and goes in one migrane generally lasting 45 mins to 3 hours long. His speech will go first but he does not suffer a droopy face. He seems to physically recover quite well with the exception of his memory. He has total memory loss surrounding the days when he is suffering a hemiplegic migraine. How does it affect your family life? Very stressful. Activities revolve around his migraine pain and recovery time. What solutions have already been proposed and/or tried? Medication first and foremost. Acupuncture, physiotherapy, aromatherapy and he was treated with bowen therapy for 2 years in Melbourne with fantastic results. This was before the

3 hemiplegic migraines developed. Since the hemiplegic migraine has developed it has been proposed he try hydrotherapy and physiotherapy which he has not yet started. The Program: The case study included 6 treatments. The first 4 were weekly, the 5th was two weeks after that and the last 3 weeks later. Results: Treatment 1 Upon initial assessment I discovered a pelvic tilt on this right side, uneven leg lengths, misaligned jaw, sinus build up and he had pain in the top right side of his head that couldn't bare to be touched. His twisting flexibility in each direction was barely 90 degrees. Treatment 2 Clients comments: Two days after the first treatment, while walking around a shopping centre, his back tightened up so much he ended up in bed with a migraine over the weekend. By the second treatment his pelvic tilt had corrected however his leg lengths were uneven again. This was due to a gluteus medius weakness. A daily excerise was given to correct this. He had a restricted piriformis muscle on his left side. His jaw remained aligned however I proceeded to do jaw work at the end of every treatment. Extra work was done to clear sinus build up so it didn t create a tension headache. Treatment 3 Clients Comments: No migraines this week After replacing a kitchen tap, pain set in afterwards from being in an awkward forward position. Up and about a lot more this week. Noticed when he wasn t moving back would tend to tighten up a bit. The third treatment showed all misalignments had corrected so I did reinforcements. I did extra work around the C1 vertebrae area for the pain in the top right side of his head and the pain never returned. I also did more sinus work. Twisting flexibility improving. Treatment 4 Clients comments: Hurt back leaning forward doing more handyman repairs around the house. Migraine after that but only for one day. Both glute muscles sore. During treatment four I found his right Quadratus Lumborm muscle had gone into spasm. This would ve tightened up his back when he wasn t moving. Mid thoracic muscles were tight. I released all muscles and performed resistance stretches with

4 the client to return his flexibility back to normal. Also released gluteal muscles and performed resistance stretches. Treatment 5 Clients comments. Headaches but no migraines. Back feeling stiff but has been out gardening and doing a lot more than he has been capable of in months. Two weeks since treatment four. Quadratus Lumborum, mid thoracic and gluteal muscle tightness still aggrevating client as he attempts to regain more movement and activity back into his life. Simple releases were made and his body responded fast. His twisting flexibility now almost 180 degrees. Treatment 6 Client comments: Feeling fantastic. No pain. No headaches, no migraines. Continuing to do daily exercises to keep pelvis aligned. Three weeks since treatment five. No misalignments. Found only a slight difference in muscle tension in left L4-L5 erector spine muscles and left jaw muscle. Twisting flexibility at 180 degrees Conclusion: In most cases migraines are triggered from a misaligned jaw or hormonal imbalance. In this case I cannot correct the inherited gene defect that caused his hemiplegic migraine but I could correct the misalignments in his body that may trigger a migraine or cluster of migraines, which have in the past, lead to the hemiplegic migraine. You will see from the results every time the client hurt his back it triggered a migraine. The client continually hurt his back during a forward leaning position which suggests his core muscles are weak and his back his compensating. The client s migraine duration and frequency had significantly decreased since starting this case study. His twisting flexibility improved over 90 degrees in each direction which will prevent a lot of stiffness and injury. The client now understands the weaknesses he needs to work on and the triggers he needs to avoid.

5 Recommendations: Core exercises. The more the client strengthens his core the less work his mid thoracics and lower back has to do. I have asked the client to continue with his daily glute medius exercises. These dysfunction specific exercises are not for flexibility they are to re-educate a weakened muscle to stabilise his pelvis and prevent tilt. Preventative maintenance is key A Bowen alignment once a month will help him to stay on top of any misalignments and keep improving his flexibility. Daily gentle exercise. Good for circulation, movement and flexibility.