Migraine: symptoms and treatment
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In our former practice in Munich, our therapist Chiara Rolle and her team offered sustainable migraine treatment with a combination of ketamine infusions, behavioral therapy, relaxation techniques and neurofeedback / biofeedback. We now offer this treatment in our clinic in Mallorcahttps://ketaminplus.com/en/ketamine-treatment
Migraine – Symptoms
Migraine, as opposed to normal headaches, usually occurs strongly and suddenly at periodic intervals, often only on one side of the head. The quality of life of those affected is severely impaired, because in addition to the severe headaches, migraine is often accompanied by other symptoms:
- nausea
- vomiting
- sensitivity to light
- sensitivity to sound
- aura symptoms, e.g.: visual impairment
Migraine treatment in our practice in Munich
A 64-year-old woman, herself a physician, consulted us in our practice in Munich for severe chronic migraine and reactive depression. The patient suffered from migraine attacks up to 200 days per year. As a result, her quality of life was very limited and she had to retire early because of the migraines.
She told us, that she found it very difficult to cope with everyday life and was only able to do so with the support of her partner: “A migraine attack can last up to 3 days, I have to lie down in bed and can’t do anything. Such a life makes no sense anymore”.
No previous treatment had so far brought satisfactory improvement.
A combination treatment with ketamine infusions, SCP neurofeedback training, and cognitive behavioral therapy was indicated (according to recent meta-analyses, cognitive behavioral therapy (CBT) can significantly reduce headache activity, intensity, frequency, and duration in chronic migraine and tension headache. The US Headache Consortium recommends KVT with evidence class A).
S1 Migraine Therapy Guidelines – 2020
“Psychological pain management techniques (pain management, stress management, relaxation techniques) should be used in patients with high-frequency migraine and significant reduction in quality of life”
“Cognitive behavioral therapy (CBT) includes cognitive-behavioral treatment strategies that are essentially designed to improve the patient’s self-efficacy and control beliefs”
“Biofeedback therapy shows high effectiveness in the prophylaxis of migraine and can be used as an alternative to medication prophylaxis”
The individualized intensive migraine treatment for this patient consisted of:
- 6 ketamine infusions (3 per week).
- 40 sessions of neurofeedback SCP training
- 20 sessions of cognitive behavioral therapy
Ketamine therapy has a mood-stabilizing effect, relieves pain, promotes cognitive performance abilities and improves neuroplasticity, i.e. the creation of new neuronal connections in the brain. Ketamine infusions lead to psychotherapy having a faster and, above all, more lasting effect. Its effectiveness in the treatment of depression has been proven beyond doubt over many years and in a multitude of medical and scientific studies.
During the first week of treatment and after 3 ketamine infusions, the patient already reported not having had a new migraine attack. The patient was able to concentrate better and was psychologically more resilient.
Psychotherapeutically, intensive work was done on stress management. Stress management is important in the treatment of any mental illness. Most mentally ill patients do not cope well with stress.
During the therapy, stress provoking situations are identified and the patient learns to deal with them. Increasing stress tolerance allows for dysfunctional emotions to be managed better.
In the treatment of depression and anxiety, internal stress triggers should be identified (anxious thoughts, self-criticism). When the patient learns to cope differently, the symptomatology of the depression or anxiety disorder is also alleviated.
In the treatment of eating disorders, the triggers that lead to dysfunctional eating behavior are identified. Here, too, it is necessary to learn how to deal with it.
Also in the treatment of schizophrenia, personality disorders, etc., actually in all mental illnesses, stress management is a very important part of therapy.
In the treatment of migraine, it is essential to lower the inner tension. By learning to better cope with stress factors, migraine attacks can be prevented.
So, together with the patient, we analyzed how everyday stress can be reduced and how she could learn to better deal with it. Together, we were able to identify which dysfunctional behaviors and thoughts exacerbate the perceived stress.
Other options in migraine treatment
Improving self-awareness through mindfulness techniques, recognizing physical symptoms of stress and practicing relaxation techniques (such as PMR) was another important part of the migraine treatment: regularly relaxing the body and mind promotes well-being and can increase pain tolerance. The prerequisite for this is that patients integrate the learned techniques into their daily routine.
Biofeedback (SCP neurofeedback training) is also successfully used in migraine treatment.
After 30 sessions, results of the training were clearly visible in the patient. She was able to change and control the “activation” and “deactivation” of her brain activity much better and reported feeling much more relaxed. During the 7 weeks of SCP neurofeedback training with 2 to 3 sessions per week, she reported having only 2 migraine attacks. We recommend at least 30 to 40 SCP neurofeedback training sessions when treating chronic migraine.
6 months after the end of the treatment, the patient reported to be still very satisfied. She benefited a lot from our combined migraine treatment, the therapy effect was very sustainable. By regularly practicing the learned therapeutic techniques, she was able to manage her stress much better and had only suffered 3 migraine attacks in 6 months, the depression had completely remitted.
If you are interested in our migraine treatment, we are happy to answer your questions personally:
