Headache Specialist

Enhance Center

Ayman Tarabishy, MD

Interventional Pain Management located in Livonia, MI

A throbbing, painful headache interferes with your quality of life. As a member of the American interventional Headache Society, Ayman Tarabishy, MD, at Enhance Center uses his training and expertise to provide lasting headache relief. The practice’s multimodal approach to treatment includes homeopathic therapies, medications, interventional nerve blocks, elimination of triggers, botulinum toxin, and ablations. The practice is conveniently located off two freeways in Livonia, Michigan. Find out how Dr. Tarabishy can help you by calling today or booking a consultation online.

Headache

What causes a headache?

A headache can bring on feelings of pain in your head, face, scalp, and beyond. The two most common forms are tension-type headaches and migraines.

Although headaches may often be very painful, they’re rarely a sign of a serious health condition. Headaches are categorized into two types:

  • Primary: not caused by another health condition
  • Secondary: caused by another health disorder, such as an infection or hemorrhage

Primary headaches include migraines, cluster headache, and tension-type headaches.

How is a headache diagnosed?

Dr. Tarabishy performs a physical exam, focusing on your head and neck. He’ll assess the functioning of your nerves, brain, and spinal cord.

He’ll ask you to describe the precise characteristics of your headache. You can expect questions like:

  • How long does it last?
  • How severe does it feel?
  • Where do you feel it?
  • How often does it happen?
  • What seems to trigger it?
  • Do you have other symptoms besides a headache?
  • How long until it reaches maximum intensity?
  • What seems to relieve your headache?

He’ll want to know what the pain feels like, such as whether it’s sharp like a knife, dull, or throbbing.

How are headaches treated?

Dr. Tarabishy takes a multimodal approach to headaches, designing a treatment plan for your precise type of headache pain.

Treatment starts by identifying and treating reversible causes of headache,

Your treatment options may include:

  • Medications
  • Botox injections
  • Homeopathic remedies
  • Elimination of triggers
  • Interventional nerve block
  • Radiofrequency nerve ablation
  • Psychotherapy
  • CSF drainage for pseudotumor cerebri sufferers with failed shunts.
  • Some intractable cases may benefit from certain nerve stimulators
  • In some intractable cases even intrathecal ziconotide can be considered.
  • IV infusions are available for intractable attacks.

As an experienced headache specialist, Dr. Tarabishy doesn’t recommend implantable occipital nerve stimulators, due to high complication rates and low rates of success providing long-lasting relief.

What is a nerve block for headache treatment?

A nerve block is an injection into the area around the nerve. A nerve block typically provides pain relief in as quickly as 15 minutes. Dr. Tarabishy performs nerve blocks in these headache-generating areas:

  • Occipital (greater, lesser and least)
  • TON (third occipital nerve)
  • Diagnostic occipital nerve ultrasound and ultrasound guided block, along with ultrasound guided inferior obliquus muscle (IOM) and semispinalis capitis muscles (SSC) in cases of muscle tension impingement occipital neuralgia
  • Supraorbital
  • Supratrochlear
  • Infraorbital
  • Mental
  • Inferior alveolar
  • Temporoauricular
  • Greater auricular
  • Sphenopalatine (trans-nasal and lateral infra-zygomatic approaches)
  • Superficial cervical plexus
  • Trigeminal or any of its branches (ophthalmic V1, Maxillary V2, Mandibular V3)
  • Gasserian ganglion
  • Buccal
  • External nasal
  • Zygomaticotemporal
  • Zygomaticofacial
  • Ascending cervical
  • EMG and Ultrasound guided specific facial muscles and/or glands botulinum toxin injections

 

Dr. Tarabishy uses Ultrasound, Fluoroscopy and sometimes CT guidance to perform the blocks.

How does Botox treat headaches?

Botox is made of a purified form of botulinum toxin. When injected, Botox blocks the release of chemicals that transmit pain signals. It also prevents the pain networks in your brain from being activated. Botox treatments may offer headache relief for up to 3 months.

If you’re ready for expert headache care, call today or book a consultation online with Enhance Center.