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Migraine Case Studies
May 20, 1997
Meridian Institute
 
 
Five individuals participated in a 10-day live-in instructional/treatment program in April, 1996, in which they were taught the elements of the Edgar Cayce therapies for migraine. The Cayce perspective is that migraine is a consequence of problems in the digestive system and enteric nervous system, rather than the brain. The therapies included dietary changes, colonic irrigations, castor oil packs, and the Cayce radial appliance. The participants then returned home to continue these therapies for 6 months, submitting daily logs of compliance with the protocol. Migraine symptoms were evaluated at the beginning of the program and after 6 months. Overall, 4 of the 5 people obtained some improvement of their migraine symptoms. Improvement was clearly related to compliance with the protocol. Stressful life events for some of the participants exacerbated their migraines, complicating interpretation of the results.

Based on the Edgar Cayce readings, the specific principles of interest included:

 - the causal involvement of the digestive system and "abdominal brain" in migraine, and
  the efficacy of dietary changes including an increase in fresh vegetables and no
  fried food.
 - the efficacy of colonic irrigations in relieving pressures in the colon said by Cayce to
   sometimes be the cause of migraine
 - the efficacy of castor oil packs in breaking up the adhesions said by Cayce to sometimes
   be the cause of migraine
 - the use of the Cayce radial appliance in equalizing circulation, analogous to temperature
   biofeedback in the conventional treatment of migraine
 - the importance of a holistic body/mind/spirit approach in working with migraine.

Here is an example of Cayce's description of the cause of migraine, from reading 3630-1:

 "As in most conditions of the nature of migraine or so-called headaches, the cause is in the colon, where there are patches of adhesions of fecal forces to the walls of the intestines, causing activities that come in general cycles. These may come at times regularly, almost so that you could set this by your clock at times. For it is the regularity of the system itself."

The therapeutic approach is a complementary one, based on the information in the Edgar Cayce readings. The project explicitly did not require participants to change their current therapies or medications. See the copy of the home treatment protocol at the end of this report.

Below are case reports based on their initial and follow-up questionnaires.

Case 1: P. E.

Summary

Case 1 is a 49 year old woman from New Jersey. She followed the protocol consistently for 6 months, and obtained some relief from her migraines. Then she ceased to do the physical aspects of the protocol (e.g., diet, radial appliance, castor oil packs) because of the difficulty of following it. When she submitted her report (11 months after the initial conference) she was having more frequent headaches, but they were much shorter in duration and less disabling. She has decreased her medication for the headaches. Her digestive symptoms are also much improved. For her, the most important aspect has been the mental/spiritual, where she feels "much improved."

Initial Questionnaire

Symptoms/Characteristics: Her headaches began when she was 13 years old. At the beginning of the project she had headaches once a month, and had had three attacks in the past 60 days. The attacks were typically 3 days long. She felt that both hormones and sleeping in an over-heated room were possible triggers.

"First day headache is one one side, left or right. Next day it seems to stop for about an hour. Then it starts on other side and lasts till 3rd day. I almost always wake up with it. But I have headaches that are not migraines that seem to develop into migraines if I don't treat them."

"Usually when I have a migraine my extremities are ice cold, I vomit, have diarrhea and usually am menstruating (though not always menstruating). If I try to walk I am off-balance and will bang into walls."

She has a prominent aura which precedes her headaches: "Aura is like jagged electricity which starts like this and gradually expands till it covers my complete visual scope - although I can see around it. Before my surgery in '92 [replacement of aortic valve in heart] the aura was silver like electricity. After the surgery it gained colors, red, green, blue, silver. Sometimes I get the aura and do NOT get a headache. Lately the frequency of auras with no headache has increased to almost every other day."

Regarding the end of the attacks: "Once I stop vomiting, I take Fioricette, if they stay down the headache will go away in 1/2 hour usually."
 
Level of Disability: "Completely debilitating. I lay in bed, have dizziness and vomit every few minutes. After a while I dry heave every few minutes. When I get up to go to the bathroom I am off-balance."

Co-morbidity: Problems with aortic heart valve; replacement with mechanical aorta valve (St. Jude Valve) in May, 1992.

Dietary/Digestive System: Yes, occasional diarrhea. "When I was on Calan I was extremely constipated." Diet: Breakfast - bagel and coffee; Lunch - sandwich and Pepsi; Dinner - chicken and 2 vegetables, water; Snack - popcorn or nachos and salsa.

Spinal Symptoms: She had whiplash 15 years previously, and usually has pains behind the right shoulder towards the center of the back. She has occasional severe lower back pain (December, 1995 and April, 1994).

Medications: Coumadin 7.5 mg daily, regulated by INR results (for heart problem). Fioricette, Tylenol, and Pamprin for migraines.

Lifestyle practices: Meditation.

Bowel Permeability: Lactulose (0.5 - normal), Mannitol (38 - abnormally high), Lacutulose/Mannitol ratio (0.013 - normal).

Results of Treatment

Compliance With Treatment Protocol

Compliance with the treatment protocol  in diet, radial appliance use, and castor oil packs was excellent for the first 6 months, although she only had the colonics given at the conference. After the first 6 months, she ceased using the castor oil packs and radial appliance, and reverted to her previous dietary habits. She said, "I believe if one follows the protocol migraines can be eliminated. It is difficult to follow. From my own experience I did well initially. Then fell off the protocol wagon."

Results

During the first 6 months, she reported improvement in her migraines. By 11 months, when she sent in her report, her headaches had become much more frequent (30 in the past 60 days vs. 3 in the past 60 days at the beginning of the project. However, the headaches had become much shorter and less disabling, her digestive symptoms were much improved, and she had decreased her medication with a corresponding decrease in side effects. In particular, her nausea and vomiting(which were the most disabling symptoms) are much improved, as are the negative alterations in consciousness. She said, "The NATURE of my migraines has changed. The headaches are more frequent but less debilitating. I plan to start the protocol again."

 
In her attached letter, she notes a major lifestyle change: she has moved into a higher paying and lower stress job. "At the 'Migraine Camp' (our program) I realized I was in a high-level, high stress job. I left Virginia determined to change that ONE thing." She is especially excited about the spiritual changes she has been undergoing, and is now only following the spiritual aspects of the protocol: "At the Migraine Camp something inside of me changed and seems to have stayed changed...I meditate daily and am having less trouble bringing my spiritual beliefs into my every day life."

Case 2: G. G.

Summary

Case 2 is a 66 year old woman from California. She complied well with all aspects of the treatment program, including having some colonics after leaving Virginia Beach. She had great improvement in her migraines. This is an example of how a combination of all aspects of the program worked together to create a very positive result.

Initial Questionnaire

Symptoms/Characteristics: Her headaches began around the age of 50. At the beginning of the project, the frequency of headaches was from 4 to 12 times per month, and she had had 15 attacks in the past 60 days. The attacks were typically 1 1/2 to 3 days long, and most ended gradually, some after sleep. There was no particular pattern or clusters. There were many different triggers, but none consistent.

On the symptom checklist, there were rare auras before attacks, involving drowsiness, nausea, sensitivity to sensory stimulation, tingling, and negative mood changes. The primary symptoms during the attack were:

 - drowsiness, lethargy sleepiness
 - nausea
 - sensitivity to sensory stimulation
 - headache on one side of the head
 - alterations of consciousness

Level of Disability: The level of disability varied, "from mildly annoying to bed for 3 days."

Co-morbidity: At the beginning of the project she also had fibromyalgia, fatigue, and "some allergies."
 
Dietary/Digestive System: Her diet was good, consisting of "some meat, chicken, fish, lots of raw and cooked vegetables, fruits and grains. She did not normally experience bowel problems such as constipation or indigestion. Her other health practices included exercises, colonics, vitamins, hot tubs, and massage.

Spinal Symptoms: She had no history of spinal symptoms.

Medications: For her migraines, she is taking Fiorinal, Imitrex, and over-the-counter analgesics. She is also taking Traqazone and antihistamines. In the past she has tried ergot pain relievers.

Bowel Permeability: Lactulose (0.5 - normal), Mannitol (32 - abnormally high), Lacutulose/Mannitol ratio (0.014 - normal).

Results of Treatment

Compliance With Treatment Protocol

Compliance with the major elements of the treatment protocol (diet, radial appliance, castor oil packs) was very good (all "2" on the 1-5 scale). She also had from 1-3 colonics after the conference (as well as the ones at the conference).

Results

Her results were excellent. Her migraine attacks were much less frequent (3-4 in the past 60 days, as compared to 15 in the 60 days before the project began). The headaches were much shorter in duration, and much less disabling. Her digestive symptoms were improved as well. She was able to decrease her migraine medication, and there was a corresponding decrease in medication side effects.

Regarding specific symptoms: The headaches themselves, when they occurred (now much less frequently) were more severe. But the other symptoms (drowsiness, nausea, diarrhea sensory sensitivity, mood changes and alterations of consciousness - were all much improved.

Her comments: "It was a wonderful program - only change the mindfulness that we all found annoying knowing it was a useful program."

"They put together all the good health practices and give impetus to follow them. Other than that I don't know why they're so much better. Suspect the good bowel practices (castor oil, colonics, etc.) help a lot."

"MSG & Nutrisweet always give me a migraine."

"I think they're practical, it's up to the people to do them. I have difficulty when traveling of course and circumstances caused me to have to, but I still improved. I was (am) pretty faithfully practicing what I now know. The radial device has contributed to faithful meditation also."

Case 3: E. T.

Summary

Case 3 is a 53-year-old woman from California. Initially she complied with the treatment protocol without much improvement until she was able to obtain colonics. She then had a major improvement, but went off the protocol, and now has migraines again.

Initial Questionnaire

Symptoms/Characteristics: Her headaches began around the age of 30. At the beginning of the project she had attacks at least once a month. She had had 6 or 7 in the previous 60 days. Her typical headache lasted 8 to 24 hours, and a maximum of 3 or 4 days. In the past they tended to occur at monthly intervals, but not recently. Stress and tension are primary triggers, as well as MSG in Chinese food, possibly menstruation, cigarette smoke, chocolate, chicken, sometimes sweets, and sinus problems. The attacks end gradually. Sleep helps, vomiting gives some relief, hot water on the face helps, and "sneezing fits are usually a good sign the attack is diminishing." She notes that "menopause seems to be changing the patterns and possibly the chiropractic adjustments. The principal cause seems to be stress, as other triggers (except MSG) are very irregular as to whether they cause an attack or not."

Level of Disability: "Usually unable to do much, sometimes blinding, totally disabling."

Co-morbidity: "Tonsils and adenoids removed when a child. One mole removed. Sinus problems, lower back pain and hip joint pain, leg pains, thinning hair, mild athlete's foot, pain in left heel."

Dietary/Digestive System: She reports "no" digestive symptoms such as constipation or diarrhea. Her dietary practices: "Each meal I eat 3 servings of vegetables and 1 serving of fruit, plus 1 starch/protein serving, 6-8 glasses of water daily, late afternoon Jerusalem artichoke snack. Tend to snack in evening or when shopping, which messes up good diet. However, snacks are "healthy" except for chocolate."

Spinal Symptoms: She has a history of spinal injury. "'Bowen Therapy' (6 treatments) for headache, wrecked my back instead. (Had recovered from a previous back injury via chiropractic.) Chiropractic helping present back pain and headaches may be less intense."

Medications: Sinusan (homeopathic for migraines), meno-fem, lipotropic, similase, vitamin E, feverfew (herbal for migraines), osteo, sometimes a few drops of glycothymoline in the water I drink, if I've eaten sweets, may prevent a migraine. Various homeopathic remedies in the past did nothing. Various painkillers only made the migraines come back worse.

Lifestyle practices: "Meditation and prayer, yoga stretches, Fastrack II exercise machine, yoga class once a week, plus the water and diet (and 8 hours sleep, when I'm behaving myself)."

Bowel Permeability: Lactulose (0.2 - normal), Mannitol (38 - abnormally high), Lacutulose/Mannitol ratio (0.006 - abnormally low).

Results of Treatment:

Compliance With Treatment Protocol

Compliance with the treatment protocol was generally good for the first 8 months of the project. She followed the diet most of the time, used the radial appliance almost every week, and castor oil packs most weeks. The key item in the protocol for her was colonics; she was unable to get them at first, but when she did, she had a major improvement in her migraines.

Results

In a telephone conversation 8 months into the project, she was overjoyed at the improvement in her headaches. She attributed the main improvement to colonics; she had been unable to find a local person to give her a colonic until recently. But when she did that, there was a great improvement in the headaches. At the time of that conversation, she felt cured. We did not receive her written report at that time, however (apparently it was lost in the mail). Three months later (11 months after beginning the project), she was no longer as positive, since the headaches had somewhat returned, apparently linked with menstruation.

Overall she reported her headaches as "less frequent," "shorter in duration," and less disabling." Her digestive symptoms stayed "about the same." She said:

"Have not gotten massages and think they would be very helpful. Have gotten weekly chiropractic treatments and if I get one when a headache is coming on, it seems to stop it, but that can't be scheduled. The first colonic I got on my own was very helpful. I did not do very good preparation or followup for the second colonic and it was less helpful. I find I cannot go off the diet at all. I may get away with it once in a while, but I never know when, and when I can't get away with it, I regret it. I think I should probably do monthly colonics and am ordering some Pro-Flora from Dr. Myatt for replacement of good beasties. The one aspect of my migraines that was not dealt with at the clinic was the hormonal. When I skipped some periods I did not get migraines, but then I started gettng monthly periods and monthly migraines again (the fluctuations are due to menopause).

Case 4: N. J.

Summary

Case 4 is a 42 year old woman from the Midwest. She was only able to follow the treatment protocol occasionally, partly due to major stressful life events and depression. Her migraines have improved somewhat.

Initial Questionnaire

Symptoms/Characteristics: Her headaches began when she was a child, and intensified in her late 30s. At the beginning of the project, the frequency of headaches was 2 times per month, and she had had 3 attacks in the past 60 days. The attacks were typically 1 to 3 days long, and tended to fade away. They were mainly clustered at ovulation and menstruation. Hot weather or heat (as from a sweat lodge) was an additional trigger, as were both eating and getting too hungry. Very bad headaches had also occurred on the weekend after a stressful week.

On the symptom checklist, there were no aura symptoms preceding the attack. The primary symptoms during the attack were:
 
 - headache on right side of head
 - sensitivity or irritability to light, sound or other sensory stimulation
 - muscle pain and spasms on right side, from base of skull to tailbone, and especially from
  neck to shoulder blade
 - pain behind right eye
 - nausea (feels sick all over)
 - constipation
 - lethargy

Level of Disability: "From very annoying to unable to work/function."

Co-morbidity: She is depressed, and stated that she has a lack of energy and interest in life. She is taking the antidepressant Serzone. She also has skin problems, specifically cystic acne.

Dietary/Digestive System: She noted on her initial form that she tended to constipation, and had "bad, bad, bad" dietary habits, including fast food, though no red meat.

Spinal Symptoms: "In grade school landed hard on gym floor on butt, could barely walk home - tiny steps. Not medically checked. Always have some pain between shoulder blades on right side."
 
Medications: Specifically, in addition to the Serzone for the depression, she is taking Imitrex injections, midrin, and ibuprofen for the headaches. She noted on the initial form that, "During several day siege, Imitrex gives relief for only few hours/part of day before migraine escalates again."

Bowel Permeability: Lactulose (1.1 - abnormally high), Mannitol (36 - abnormally high), Lacutulose/Mannitol ratio (0.030 - normal).

Results of Treatment

Compliance With Treatment Protocol

Compliance with the treatment protocol was generally poor. She only occasionally (4) followed the diet, never (5) did castor oil packs, and only had the colonics given at the conference. She used the radial appliance for the first 2 months, and then ceased using it. Her daily logs revealed consumption of a fair amount of fast and junk food, and few vegetables.

Results

Both her attitudes and emotions and her frequency of migraine attacks improved (2) on the 1 to 5 scale. After 7 months in the project, she had 2 in the past 60 days. One lasted 3 days, and 1 was not a full attack. Her attacks were shorter in duration, and much less disabling. Her digestive symptoms were improved, and she was able to decrease her medications for migraine.

Her compliance with the protocol and results are complicated by her concurrent struggle with depression. "I was battling fatigue and depression that made it diffcult to have oomph to do treatment plan or to even care. Then father's death tipped me over more. The depression and fatigue have recently improved a great deal. I attribute this to having started a supplement regimen, including a multivitamin, enzymes, iron, ginseng, spirulina, bee pollen, royal jelly, Co Q 10, echinacea, etc. I wonder if I was depleted enough that I need a 'jump start.' I wonder if the enzymes to aid the digestion/utilization process weren't of particular benefit. Someone else may also benefit from supplementation. (I know this isn't necessarily Cayce but it could help.)"

"I just found out about a private dietician service in town that charges only $10 per visit to hep people stay on their diets. You meet with a registered dietician and review how you're doing. I know this would have been helpful to me and I believe I will make arrangements yet to do it. It might also be a useful suggestion for others. (One is more likely to practice piano if there is a lesson to attend.) Even going every other week at $20 per month is ridiculously cheap if it helps."

Specific symptoms: "Major preceding symptoms are feeling of heaviness and body not quite right (sicky feeling, not necessarily nausea). This has stayed the same."

There were improvements in nausea, vomiting (no incidences), constipation, and post-migraine depression. Interestingly, she became more aware of the alterations of consciousness she had previously had during attacks, as they improved. "I didn't think this happened to me before, but realize it did - I'll walk crooked, list to the left usually."

Conclusions

It is difficult to tell what caused the improvement in this case. The improvement of her depression and the possible effects of the antidepressant are one possibility; the dietary supplementation is another, even though she did not follow the Cayce diet. Another is that even the 10-day cleansing experience in the conference and her 2 months use of the radial appliance set up a process that helped reduce the headaches.

Case 5: J. K.

Summary

Case 5 is a 59 1/2 year old woman from the state of Washington, with daily migraines. Her case is very complex, as her migraines apparently originated in a head injury which also resulted in epileptic-like EEGs without epileptic seizures. She also has ulcers and colitis, as well as food sensitivities. Except for the diet, which she followed to some degree, she was unable to follow the physical aspects of the protocol. Her migraine symptoms are unchanged but she feels she has had some mental/spiritual improvement.

Initial Questionnaire

Symptoms/Characteristics: This woman had the most severe migraines of any of the patients, and also the most complex set of symptoms and co-morbidity. Her attacks began at the age of 35, following a severe car accident in 1971, decreased in frequency for several years, and appeared again at the age of 49 during menopause. They occur "daily, sometimes medium intensity, sometimes excruciating." She has had 60 attacks in the past 60 days. She says, "Excruciating headaches last anywhere from 12 hours to 72 hours, but it seldom completely leaves me." There is no particular pattern to the headaches, just variation in intensity. A wide variety of circumstances trigger the headaches, ranging from sensory stimuli to emotional stress. She has a particularly stressful job, as a counselor at a women's prison. She says, "Excruciating headaches may ease abruptly, others when I go to bed. They only rarely completely end."

On the symptom checklist, the migraine symptoms and the auras before the attacks are basically the same, reflecting the almost constant nature of the headaches. The worst symptom is a headache on one side of the head. Other significant symptoms include:

 - diarrhea
 - nausea
 - sensitivity or irritability to light, sound, or other sensory stimulation
 - visual effects/hallucinations
 - muscles spasms
 - major negative mood changes
 - alterations of consciousness

Level of Disability: "Excruciating ones are very disabling. I find it difficult to think, difficult to perform my work, difficult to interact with people."

Co-morbidity: As noted below, includes duodenal ulcer, inflammatory bowel disease, allergies, head injury (later EEG revealed epileptic signs), back pain, fibromyalgia, depression.

Dietary/Digestive System: Her digestive problems include a duodenal ulcer, inflammatory bowel disease, and various allergies and sensitivities

Spinal Symptoms: "Chiropractor states there is evidence of tailbone fracture; injured my spine as well as a fractured pelvis and severe concussion to left forehead leaving a permanent dent in a severe automobile accident in November, 1971 in which I was broadsided. I have shoulder and upper back pain, sometimes lower back pain, also neck pain, chiropractor says fibromyalgia.

Medications: Numerous medications, either now or in the past, including standard migraine medications such as Imitrex and Fiorcet, as well as several different antidepressants, antiseizure medications, and antianxiety medications.

Bowel Permeability: Lactulose (0.1 - normal), Mannitol (17 - normal), Lacutulose/Mannitol ratio (0.006 - abnormally low).

Results Of Treatment

Consistency of Following Treatment:

Compliance with the treatment protocol was variable. She followed the diet most of the time (2), and at first used the radial appliance most weeks, but stopped because of a negative physical reaction. She only did castor oil packs a few times (4), and her only colonics were the ones at the conference. Her complex medical condition made greater compliance difficult.

Changes in Migraine Symptoms:

Her migraine symptoms are still about the same, although her attitudes and emotions have improved. She still has daily migraine attacks; the attacks are longer than when she began the project. Sometimes they are less disabling, sometimes more disabling. Her digestive symptoms (colitis) are worse, and she notes that the colitis is sometimes worse when the headaches are better, and sometime worse with severe headaches. She has increased her medications, adding an antiseizure medication.

She attached a letter, which is quoted below in full:

"I wanted to give a little more information than the space on the questionnaire provided."

"On September 23rd I got the results of an EEG I had done and the results were that my brain waves are abnormal. That is, they were similar to persons who have epilepsy. Only in my case, it is apparently causing migraines instead. Although, I have had a few spells when I felt weird and had some shaking. So hopefully, I won't progress to having seizures. I am now taking neurontin, an anti-seizure medication, 600 mg., 3 times a day. The neurologist feels it is from scar tissue from my head injury in the car accident 25 years ago. Interestingly, the EEG's I had taken years ago, didn't show this."

"I had some strange reactions to the radial appliance. The last time I used it, I had numbness and almost a paralysis on the left side of my body. I told Kieth about it on the phone, and he recommended I not use the appliance without consulting the rest of you. I have had other reactions now and then, including chest pain on the left side."

"My diet is still limited because of all my allergies. About the only grain I can eat is rice. Soy also seems to bother me, digestion wise. And of course, there are the foods that cause migraines I have to avoid. And sugar, because of my hypoglycemia. I plan to see a naturopath in the near future to see if he/she can straighten out my food allergies. According to my gastroenterologist, both my ulcer and colitis are caused by allergies (food). My ulcer is better, I am still bothered quite a bit by colitis."

"As you can see by my answers on the questionnaire, I still have the headaches. Perhaps they are not as severe all of the time. However, I have recently begun having severe three day headaches and don't know how to account for that. Also, I documented on several occasions, having severe headaches a few hours prior to an earthquake, both in Washington state and in California and Alaska. This is where the earthquakes were centered."

"Also, as an afterthought, on the radial appliance, I had a few more instances of it sizzling when I pulled the electrode out of the appliance after using it." [Note from Doug Richards: it is not unusual to hear a sizzling sound as the appliance is warming up, after it has been submerged in the ice water.]

"I do believe my attitude towards my headaches has improved. I believe I owe this to meditation and listening to meditative music at home. I seem to be better able to deal with and ignore the pain, if that makes any sense."

"I wish that my headaches had been cured and I am still hoping to find the answer somehow, someday."

Conclusions

The complexity of this case, particularly the head injury and epileptic-like brain waves, suggests that it does not fit the pattern of migraines seen in the Cayce readings. Nevertheless, the presence of colitis and ulcers do suggest a disgestive system involvement. Perhaps this patient might have obtained better results, had she had more colonics, and used castor oil packs on a regular basis. But a Cayce reading for this patient would likely have given a more elaborate and specific treatment. It is encouraging that the mental/spiritual aspect of the project seems to be helping. This is also an example of a case where continuous monitoring of progress and support would help in guiding the treatment path.

 

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