Revisiting the expanded use of hyperbaric oxygen therapy for treatment of resistant migraines

David V Matera, Brian Smith, Benjamin Lam, David V Matera, Brian Smith, Benjamin Lam

Abstract

There are currently 13 indications approved by the U.S. Food and Drug Administration for use of hyperbaric oxygen therapy. The European Consensus Conference on Hyperbaric Medicine has 28 indications approved for its use. However, neither includes the use of hyperbaric oxygen therapy for neurological conditions such as migraines with aura. Recent research has made the attempt to fully understand the use of hyperbaric therapy in treatment of neurological conditions, but results have so far been inconclusive. We report a 23-year-old female with an 11-year history of migraines with aura who has received inadequate pharmacological treatment for her migraines since she began having them. Migraines have led her to significant loss of function. The patient underwent treatment at 1.5 absolute atmospheres in a hyperbaric chamber Monday through Friday for 1 hour each day for a total of 40 sessions but reported missing a few sessions over the 8-week period. No more than 1 session during a given week was missed and the patient received no other treatments for her migraines throughout this time period. By her 24th treatment, the patient had only experienced a single migraine with aura but without debilitating pain. The patient stated she had never had a migraine with such little intensity prior to initiation of hyperbaric treatment and did not have to take any days off from work or school. Follow-up at the end of her 40-day treatment period revealed a highly-satisfied patient who had only experienced the single episode of a mild migraine during the entire course of treatment. Thus, we believe that further research needs to be done to realize the full potential of hyperbaric oxygen therapy in the treatment of neurological conditions as this case highlights the potential for using hyperbaric oxygen therapy as prophylaxis against attacks in patients with treatment resistant migraines with aura.

Keywords: aura; hyperbaric chambers; hyperbaric oxygen therapy; indications for hyperbaric oxygen; migraine with aura; migraines; vascular headaches; vasoconstriction.

Conflict of interest statement

Conflicts of interest

None.

References

    1. Yildiz S, Uzun G, Kiralp MZ. Hyperbaric oxygen therapy in chronic pain management. Curr Pain Headache Rep. 2006;10:95–100.
    1. Niinikoski JH. Clinical hyperbaric oxygen therapy, wound perfusion, and transcutaneous oximetry. World J Surg. 2004;28:307–311.
    1. Tibbles PM, Edelsberg JS. Hyperbaric-oxygen therapy. N Engl J Med. 1996;334:1642–1648.
    1. Leach RM, Rees PJ, Wilmshurst P. Hyperbaric oxygen therapy. BMJ. 1998;317:1140–1143.
    1. Gill AL, Bell CN. Hyperbaric oxygen: its uses, mechanisms of action and outcomes. QJM. 2004;97:385–395.
    1. Fife CE, Eckert KA, Carter MJ. An update on the appropriate role for hyperbaric oxygen: indications and evidence. Plast Reconstr Surg. 2016;138:107S–116S.
    1. Jain KK. Textbook of Hyperbaric Medicine. Cham: Springer International Publishing; 2018.
    1. Weaver LK. Hyperbaric Oxygen Therapy Indications. 13th ed. Durham, USA: Undersea and Hyperbaric Medical Society; 2014.
    1. Bennett MH, Mitchell SJ. Emerging indications for hyperbaric oxygen. Curr Opin Anaesthesiol. 2019;32:792–798.
    1. Al-Waili NS, Butler GJ, Beale J, et al. Hyperbaric oxygen in the treatment of patients with cerebral stroke, brain trauma, and neurologic disease. Adv Ther. 2005;22:659–678.
    1. Mathieu D, Marroni A, Kot J. Tenth European Consensus Conference on Hyperbaric Medicine: recommendations for accepted and non-accepted clinical indications and practice of hyperbaric oxygen treatment. Diving Hyperb Med. 2017;47:24–32.
    1. Goadsby PJ, Lipton RB, Ferrari MD. Migraine--current understanding and treatment. N Engl J Med. 2002;346:257–270.
    1. Moskowitz MA. Neurogenic inflammation in the pathophysiology and treatment of migraine. Neurology. 1993;43:S16–20.
    1. Charles A. The pathophysiology of migraine: implications for clinical management. Lancet Neurol. 2018;17:174–182.
    1. Wilson JR, Foresman BH, Gamber RG, Wright T. Hyperbaric oxygen in the treatment of migraine with aura. Headache. 1998;38:112–115.
    1. Celik O, Bay HH, Arslanhan A, et al. Effect of hyperbaric oxygen therapy on cerebral vasospasm: a vascular morphometric study in an experimental subarachnoid hemorrhage model. Int J Neurosci. 2014;124:593–600.
    1. Dodick DW. A phase-by-phase review of migraine pathophysiology. Headache. 2018;58(Suppl 1):4–16.
    1. Ferrari MD, Klever RR, Terwindt GM, Ayata C, van den Maagdenberg AM. Migraine pathophysiology: lessons from mouse models and human genetics. Lancet Neurol. 2015;14:65–80.
    1. Bosco G, Vezzani G, Mrakic Sposta S, et al. Hyperbaric oxygen therapy ameliorates osteonecrosis in patients by modulating inflammation and oxidative stress. J Enzyme Inhib Med Chem. 2018;33:1501–1505.
    1. Matchett GA, Martin RD, Zhang JH. Hyperbaric oxygen therapy and cerebral ischemia: neuroprotective mechanisms. Neurol Res. 2009;31:114–121.
    1. Myers DE, Myers RA. A preliminary report on hyperbaric oxygen in the relief of migraine headache. Headache. 1995;35:197–199.
    1. Eftedal OS, Lydersen S, Helde G, White L, Brubakk AO, Stovner LJ. A randomized, double blind study of the prophylactic effect of hyperbaric oxygen therapy on migraine. Cephalalgia. 2004;24:639–644.
    1. Bennett MH, French C, Schnabel A, Wasiak J, Kranke P, Weibel S. Normobaric and hyperbaric oxygen therapy for the treatment and prevention of migraine and cluster headache. Cochrane Database Syst Rev. 2015:CD005219.

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