THE HEADACHE CLINICS
featuring:
The Headache and Facial Pain Program
University of Cincinnati College of Medicine
Cincinnati, Ohio
Vincent Martin MD; Reena Shah, MD; David O’Hare, Medical Assistant
The Headache and Facial Pain Program, at the University
of Cincinnati College of Medicine, in Cincinnati, Ohio,
was established in October, 2013. It is part of the UC Neuroscience Center. Although this program is fairly new, the
university has a long tradition of headache clinics. Robert
Smith, MD started one of the first headache clinics in the
U.S. at the University of Cincinnati and it was staffed by
primary care physicians. This Clinic was started during the
late 1970s and continued through 1990.
The following is based on an interview with the Program’s Co-Director, Vincent Martin, MD. Doctor Martin
is also Professor of Clinical Medicine in the Division of
General Internal Medicine, at the University of Cincinnati
College of Medicine.
Doctor Martin attended medical school and completed
his residency and fellowship in General Internal Medicine
at the University of Cincinnati. He was able to study
under Doctor Smith and was exposed to the practice of
headache medicine. Doctor Martin is board certified by
the American Board of Internal Medicine, board certified
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Volume 4, Issue 2 • 2014
in Headache Medicine by the United Council for Neurologic Subspecialties, and is a Diplomat of the National
Board for the Certification of Headache Experts. He is a
Fellow of the American College of Physicians and a Fellow
of the American Headache Society. He was elected to the
Board of Directors of the National Headache Foundation
in 2009, and has served as its Vice President since 2011.
Doctor Martin is also President of the Ohio Headache
Association.
The Program at the University of Cincinnati is a
multidisciplinary group of headache physicians and other
specialists (ENT, dentists, pain medicine, neurosurgeons).
Their goal to treat the wide array of headache and facial
pain disorders with a multidisciplinary approach. This
Program is one of the only centers in the Midwest to treat
both headache and facial pain.
In addition to Doctor Martin, the members of the staff
include: Joe Nicolas, MD; Reena Shah, MD; Walter McFarland, MD (see staff graph).
To be seen at the Center, patients do need a referral from
another physician. Generally, the wait for an initial evaluation is 2 to 3 months, but there is a waiting list. Adolescents
(14 years and older) and adults are seen at the headache
center. A pediatric headache clinic is located elsewhere at
the University of Cincinnati. Prior to the initial visit, patients will need to complete some questionnaires regarding
their past medical history. While at the Clinic, the patient
will undergo a comprehensive history and physical examination. During the visit, the patient will only be seen by a
physician, and the visit will take approximately 2 hours. If
needed, laboratory testing and MRIs can be performed in
the same building. Any other tests would be completed at
the adjacent hospital.
At the Clinic, the treatment philosophy is a holistic
therapeutic approach to the headache patient, assisting
them in identifying trigger factors that could be increasing
the frequency of their headaches. Because of the multidisciplinary staff, an integrative approach is provided to
each patient. The Integrative Medicine department offers
acupuncture, relaxation techniques, dietary therapies, aroma therapy, yoga, etc. For the refractory headache patient,
inpatient therapy is available. A Clinic physician would
follow the patient if hospitalization is required. Currently,
there is not a dedicated unit at the hospital for headache
patients, but Dr. Martin advised that they are trying to
develop a headache inpatient facility.
At the Clinic, the staff have particular expertise in hormonally-triggered migraine in women and in headaches
that occur in patients with connective disease disorders (eg
Ehlers Danlos Syndrome, Marfan Syndrome, Joint Hypermobility Syndrome). In addition, the Clinic has published
studies regarding the relationship between migraine and
sinus disease/rhinitis (hay fever).
In regards to growth or changes to the Clinic during the
next few years, Doctor Martin expects an increase in the
number of physicians on the staff in the near future. At the
Clinic, research continues into the relationship between
migraine and female hormones. In a recent presentation
at the annual meeting of the American Headache Society,
they noted that perimenopause was associated with a 50
to 60% increased risk for headache as compared to premenopausal women with migraine. They are continuing
research on the role of allergies and sinus disease and migraine. Also, they are undertaking a study to determine the
relationship between migraine and joint hypermobility or
Ehlers Danlos syndrome.
When asked what he enjoyed most about working in
headache medicine, Doctor Martin noted that his most
satisfying experience is in helping headache patients -“There is n