Complex Migraine Resolved INSTANTLY

Resolving Chronic Migraine with Ocular Complications: A

Case Study

Author: Dr. Christian DiStefano, D.Ac.

Contact: scarsdalehealth@gmail.com

Executive Summary

This paper shares the case of a 44-year-old woman who came to our clinic with four weeks of relentless migraine pain and troubling eye symptoms—redness and drooping of the right eyelid. She had already seen multiple neurologists and even a neuro-ophthalmologist, yet none offered lasting relief. During her first visit, I treated trigger points in her sternocleidomastoid (SCM) muscle using dry needling. Within minutes, her pain dropped by half, the redness in her eye began to clear,

and her eyelid nearly returned to normal. Over just three sessions, she achieved complete resolution.

This case highlights an often-overlooked contributor to stubborn migraine cases: dysfunction in the cervical musculature.

Key Outcomes

- 50% pain relief within minutes of the first treatment

- 80% reduction in eye redness during the initial session

- 90% improvement in eyelid drooping after first treatment

- 80% symptom relief still present four days later

- Full resolution after three total sessions

Background

Migraines that involve eye symptoms can be incredibly difficult to treat. Standard neurological approaches sometimes fall short, leaving patients discouraged and still in pain. One reason is that the muscular system, particularly the cervical muscles, is often left out of the conversation.

The sternocleidomastoid muscle, which connects the head, neck, and upper spine, has direct neurological relationships with both the trigeminal system and upper cervical nerves. When irritated or tight, this muscle can mimic or drive migraine symptoms—headache, eye redness, drooping eyelids, and restricted neck movement. This case demonstrates how important it is to assess and treat the musculoskeletal system in patients whose migraines don’t respond to conventional care. Case Presentation

Patient Profile

- Chief Complaint: Severe right-sided headache with eye symptoms, lasting four weeks

- Previous Care: Consulted multiple neurologists, tried medications with little benefit and significant side effects

- Recent Consultation: Neuro-ophthalmologist discouraged further treatment, specifically dismissing acupuncture

Initial Presentation

On arrival, the patient reported an 8/10 right-sided headache, constant redness in the right eye, and noticeable eyelid drooping. She also had limited neck rotation and significant functional impairment due to pain.

Clinical Assessment & Diagnosis

The combination of a one-sided headache, eye involvement, and limited cervical movement suggested a musculoskeletal cause rather than purely neurological. The sternocleidomastoid muscle stood out as the likely driver of symptoms, due to its anatomical links and the patient’s pattern of complaints.

Working Diagnosis: Chronic migraine secondary to sternocleidomastoid trigger point syndrome with cervical dysfunction.

Treatment Approach

The treatment strategy aimed to relieve immediate symptoms and restore balance to the neck

muscles. Three primary steps were used:

1. Dry needling of three trigger points in the right SCM

2. Balancing treatment with contralateral SCM and levator scapulae

3. Ongoing structural rebalancing to prevent recurrence

Outcomes & Results

First Session

- Pain dropped by 50% (from 8/10 to 4/10) within minutes

- Eye redness improved by 80% in the same session

- Eyelid drooping improved by 90%

Follow-upAt the 4-day follow-up, 80% of the improvements held. The patient reported being able to function much more easily in her daily life.

Treatment Completion After three total sessions, the patient’s migraines and eye symptoms had completely resolved and did not return during the follow-up period.

Discussion

This case emphasizes the importance of considering the muscular system in migraine care.

The rapid and dramatic response after treating the SCM suggests that this muscle was not a secondary factor—it was the main driver of her symptoms.

By treating both the dysfunctional side and the compensating muscles, we were able to provide lasting relief. This approach shows that musculoskeletal interventions should not be an afterthought in chronic headache cases but considered early in the treatment process.

Conclusion

This patient’s complete recovery after three treatments demonstrates how powerful targeted musculoskeletal work can be. For patients who have tried standard neurological approaches

without success, addressing the cervical muscles—especially the sternocleidomastoid—can be life changing.

Key Takeaways:

1. Always include cervical muscle assessment in treatment-resistant migraines.

2. One-sided headache with matching eye symptoms should raise suspicion of SCM

involvement.

3. Immediate symptom change after treatment can confirm the muscular source.

4. Treat both sides to address compensation in chronic cases.

5. Even after discouraging experiences, persistence and advocacy can lead to full resolution.

Clinical Note

This case study is presented for educational purposes. Each patient is unique, and treatments

must always be tailored to the individual. Patient consent was obtained for this case report.