INLSA

NEW VIEW: Migraine specialist Dr Elliot Shevel believes the world is wrong about the way scientists approach migraines. Picture: Mujahid Safodien

THANDI SKADE

A TOP JOBURG migraine specialist heads for Vienna, Austria, next year to argue for a change in the way migraines are classified.

Dr Elliot Shevel, founder and medical director of The Headache Clinic, believes that the current International Headache Society’s classification of a migraine, based on symptoms, is wrong and should be amended.

The method has been in use for more than three decades, but Shevel says specialists should rather be looking at pinpointing where the pain is coming from rather than the symptoms – typically a throbbing, one-sided headache, nausea, sound and light sensitivity – the patient experiences.

The Headache Society is the official migraine research body of the World Health Organisation.

Specialists believe migraines originate from a problem within the brain, and that there’s no muscle component in migraines.

But Shevel says most migraines occur outside the brain and that pain comes from two structures – the muscles of the jaw and neck and the arteries in the scalp.

“They’ve (scientists) done experimentation before where they’ve stretched blood vessels and it has caused nausea so it fits in with migraines. But what they don’t realise is that muscle pain also causes nausea. So, if a patient has nausea it doesn’t tell you whether it’s from the muscle or the artery. That’s why a symptom doesn’t make a difference, you’ve got to know where the pain is coming from,” he said.

For years Shevel and his colleagues at The Headache Clinic have diagnosed migraines based on the physical structures in the body that are causing the pain.

Following a neurological examination, doctors test for muscle tenderness with an electromyography, an instrument used in the diagnosis of neuromuscular disorders.

“When a person has a headache, those spots will be more tender. To make doubly sure, we inject the spot with local anaesthetic. If the pain goes away, then we know the pain is caused by muscle tension and we can then treat for muscle tension,” he said.

To determine if the pain stems from the arteries, an inflatable band is placed around a patient’s head that blocks off all of the arteries around the head. If a patient feels relief from the pain, then they can treat for arterial pain.

Shevel has been invited to present his case at the Congress for Controversies in Neurology in Vienna in March.