Predicting the Epicenter of Recurring Pain in Migraine Headache Patients

Objectives: When the pain of a migraine headache strikes, it repeatedly manifests in the very same site on the head. A novel technique of predicting the epicenter of headache pain was tested in this study.
Methods: Migraine headache patients (n25) and non- headache controls (n27) were examined by manually palpating each upper tooth individually as the subject tapped their teeth together.
After the tooth exhibiting the greatest intensity of vibration (IV) was identified, an imaginary line from this tooth to the cranium was used to feel for the place which also demonstrated more (IV) or greater tenderness compared to adjacent areas as the subject tapped.
The examiner was blinded to all subjects of both groups. In the migraine group, it was not a requirement for the subject to have a headache at the time of the examination.
The results of the examination were compared to a pre-examination form filled out by the subjects to determine if the examiner's prediction coincided with the subjects actual epicenter of typical headache pain and to see if the examiner could also distinguish between migraine and non-headache subjects using this method.
Results: The examiner was able to correctly identify the epicenter of headache pain in 84% of the migraine headache group and predict the presence or absence of migraine correctly 62% of the time. The headache site residing in the frontal bone appeared to be directly above the identified tooth in the anterior region and followed the fibers of the temporalis muscle in the posterior region.
Conclusions:
The ability to predict the location/epicenter of chronic headache pain with a surprising degree of accuracy simply by using manual palpation suggests that the dentition plays a significant role not only in determining the location of a migraine but also may aid in confirming the diagnosis of a migraine headache.