The Autonomic Nervous System and its Relationship to Headache by Dr. Dietrich Klinghardt, M.D.

, PhD Thomas Willis, the "father" of modern neurology, proposed the vascular theory of headache in 1 !". #e suggested that the source of pain $as not the brain itself but nerve fibers being pulled by the distended vessels%1& #arold Wollf reported in 1'() on the autonomic nervous system %*+,& involvement in migraine headaches- he postulated that the primary cause of migraine is vasoconstriction of the e.tracranial arteries in the early phases of the headache follo$ed by vasoconstriction /$ith associated peripheral vasoconstriction in the limbs%"&. 0ther signs suggesting *+, involvement in headache include nausea, diarrhea%(&,constipation %1&, coldness in hands and feet, paro.ysmal tachycardia %2&, chest pain % &, variant angina %!&, paraesthesia and numbness of the s3in and others. The vascular theory of migraine $as the generally accepted $or3ing model until the cell receptor theory came along around 1'!). 4n 1')5 +obel pri6e laureate Paul 7hrlich postulated the e.istence of cell receptors, $hose interaction $ith specific agents $as a mechanism responsible for many illnesses. 8eceptor biochemistry has become the basis for most pharmacological approaches. * recent e.ample is the development of the drug sumatriptan $hich attaches to the 2/#T1 receptor. 0ther receptors involved in headache include the alpha/" receptors, u/opioid receptors and somatostatin receptors. 9ntil today there are numerous theories on the neurophysiology of headache, none of $hich are completely proven%5&. Anatomy To understand the role of the *+, in headache, the anatomy has to be understood. The *+, serves three basic functions in the brain1. 4nnervation of the smooth muscle of the vascular tree $ithin the brain. * stress signal $ithin the sympathetic nervous system $ill generally lead to vasoconstriction in the affected area of the brain. ". Transport of neuropeptides and informational substances $ithin the a.ons of the *+, into the terminals $ithin the vascular endothelium. ,everal do6en substances travel via the *+, a.ons to the endothelium and are released into the bloodstream, causing both local and systemic effects. ,erotonin, en3ephalin, nitric o.ide and the inflammatory peptides such as substance P, neuro3inin * and calcitonin gene related peptide are thought to be involved in the genesis of migraine pain. (. 5): of *+, fibers are thought to be sensory in nature and may be directly involved in pain perception. ,ensory autonomic nerves are present in the cranial membranes %dura, arachnoid, tentorium&, in the connective tissue and in the $alls of the larger blood and lymphatic vessels. The *+, is 3no$n to have a $ind/up effect %sensiti6ing effect& on the $ide dynamic range%WD8& cells in the spinal chord, $hich modulate the pain path$ay. 4f pain originates for e.ample in the trigeminal system, this message has to pass through the WD8 cells. 4f the threshold is lo$ered by arousal of the sympathetic nervous system in the same segment, the pain message passes through the WD8 cell up into the brain. *rousal in the *+, can be caused by any e.citatory stimulus acting on the a.ons, nerve endings or ganglia of the *+,. ;ommon in the dental arena are abnormal electrical signals %"abnormal signaling"& arising from dysfunctional scars %from tooth e.tractions or surgical procedures& or from dysfunctional teeth %decay, incompatible restoration materials, mechanical stress, to.icity from filling materials and infections etc.&. The dental pulp has its o$n autonomic nervous system mostly comprised of sympathetic fibers traveling piggybac3 on the arteries, veins and lymphatic vessels of the

tooth pulp. The fibers are post/ganglionic and arise in the anterior cervical ganglia %stellate, middle/ and upper cervical sympathetic ganglia& and travel to the teeth piggybac3 on the vessels and trigeminal nerve fibers&. *ny dysfunction in a tooth or related structure %muscles of mastication, periosteum, dental ligaments, <a$ <oint capsule& may cause arousal in the ad<acent sympathetic fibers, causing local or systemic electrical chaos in the *+,, $hich in turn can often result in the clinical picture of headache. This includes organic headaches, tension headache, cluster headache, TM=>dental related headache, migraine headache, cervicogenic headaches, sinus headaches and others. Treatment Options 0nly three treatment systems have evolved that utili6e the current understanding of the *+, involvement in headache patients in a sophisticated manner1. *cupuncture ". ?iofeedbac3 (. +eural Therapy +eural Therapy is a treatment modality developed in @ermany over the last !2 years that adresses dysfunction of the *+, in a targeted and specific $ay. 0ther treatment modalities certainly $or3 by modifying the *+,, such as chiropractic, cranio/sacral therapy etc., but the practitioner is rarely a$are of this fact and is not utili6ing the current physiological and anatomical 3no$ledge base to further improve s3ills and results. Health issues that affect the ANS 8esearch has sho$n that the *+, is commonly disturbed by a selected number of factors1. Membrane instability caused by nutritional and hormonal deficits %i.e.- a number of nutrients, such as aminoacids, minerals and vitamins are reAuired for the daily nutrition of a nerveB D#7* and pregnenolone have a membrane stabili6ing effect&
". Food allergies (. Toxicity from metals and solvents - mercury to.icity destroys the en6yme that ma3es tubulin, a ma<or structural component of every nerve a.on 1. motional factors - unresolved psycho/emotional issues create chronic arousal of the sympathetic nervous system via the limbic/hypothalamic/*+, a.is. 2. Occlusal problems- healthy proprioception has a suppressive effect on pain messages traveling through the WD8 cells, poor proprioception facilitates pain signals. Poor occlusion also stimulates abnormal *+, signals in the *+, nerve endings in the involved structures . !hronic infections %especially in face and <a$&- to.ins from teeth are often neuroto.ic, interfering $ith the healthy function of a nerve !. 7lectromagnetic and other man/made biophysical stress- nerve conduction is the spreading of an electric field along the a.on of a nerve. Man/made electric and magnetic fields can interfere $ith that function, often leading to lasting dysfunction, even if the no.ious input is removed

5. The"interference field %4C&" or "focus". * focus is a group of cells that is disturbing to the system. * focus most often causes problems a$ay from the site of the focus. Therein lies the main problem- ho$ to find it. * focus can be a chronic osteomyelitis in the <a$, from $here bacteria e.it and settle in other specific target sites in the body %infectious focus&. 4t can also be a group of cells that has been in<ured %through scalpel, trauma or illness&. These cells can become impulse generators, creating small bursts of electric impulses, $hich travel $ithin the *+,, causing problems often far a$ay from the disturbed site %electric focus&.

"iagnosis The follo$ing diagnostic approaches have emerged in the last () years, that are able to assess dysfunction of the *+, and>or locate a focal area1. #eart rate variability testing ". Thermography (. 7lectrodermal screening %7*D& 1. *utonomic response testing %"3inesiology", "muscle testing"& 2. Palpation>clinical e.am . ;hinese pulse diagnosis %also D*,& Treatment The treatment consists in an appropriate intervention that eliminates or treats the disturbing factor. #ere is a list of common solutions that have emerged in the 7uropean +eural Therapy conte.t 1. !luster headache# the focus is usually a small area inside the nose, $here the middle turbinate touches the nasal septum. Treatment is either in<ection of the area $ith normal saline or procaine or a series of sphenopalatine ganglion in<ections. ". Migraine- the focus is usually a scar, $hich can be any$here on the body. @allbladder, hernia, hip surgery and appendi. scars are most common. Treatment is in<ection of the scar $ith saline or procaine. *lso food allergies are common. To test most common foods, the ;oca pulse test is the most reliable and cost/effective method- establish your resting heart rate, eat the suspected food. 4f your rate increases by 1 beats>min or more, avoid the food. (. !ervicogenic headache %common after $hiplash in<uries&- the focal area is the superior cervical ganglion and the in<ured autonomic fibers in the upper cervical facet <oint capsules. Treatment is a series of in<ections to the ganglion $ith procaine and facet <oint in<ections of a mi. of procaine and proliferant %such as P"@, $hich is a phenol, de.trose and glycerine mi.&. 1. Trigeminal neuralgia and atypical facial pain- the focus is usually a <a$ bone infection or +4;0 lesion, $hich has to be found and surgically eliminated. 2. Tension headache# the cause is usually an unresolved emotional childhood trauma, $hich has to be uncovered, ree.amined and reprocessed. TechniAues such as hypnotherapy, 7MD8, +7T or psycho/ 3inesiology %PK& are ideal. . Sinus headache# this type of headache is the great mimic- it can loo3 and present li3e any of the other ma<or types of headache, but also present as severe nec3 pain only. Treatment consists of treating a set of perivascular *+, points in the face or performing a series of sphenopalatine ganglion bloc3s. !. TM"$dental headache# again, the pain syndromes caused by pathology of the oral cavity can present in many different $ays, mimic3ing other types of headache. Treatment for a dental headache is a& diagnostic anesthesia to the affected tooth, preferably using the stabident system, b& appropriate intervention. Cor TMD related pain usually a mi. of several procedures is reAuired- a& correcting the plane of occlusion and the shape of upper and lo$er arch b& elimination of trigger points c& stellate, ,P@, otic ganglion and vagus ganglion in<ections. *l$ays consider unresolved emotional issues. Results The overall cure rate for headaches $ith this approach is high. +eural Therapy and autonomic response testing are techniAues $ith e.tremely high benefit>ris3 ratio and can be mastered by any licensed health care practitioner.

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