Functional Neurology: Part 2
Written & Edited By: Caroline Griffin
Special Guest: Dr. Lauren DeStephano, DC, DACNB
Date Published: May 2, 2022
Part 1 of our interview with Dr. Lauren DeStephano provided an in-depth exploration into the topics of depression, chronic illness, underlying conditions, patient education and empowerment, and how our eyes can provide direct insight into how our brains are functioning.
In Part 2 of our interview, Dr. DeStephano explains what migraines are on a cellular and nervous system level, how eyes can provide a window into the functioning patterns of the brain, a dysautonomia success story, and recovering from COVID and COVID long-haul symptoms. She also shares some excellent resources at the end of the interview to help you get started on learning more about Functional Neurology.
First, we talked about migraines.
Migraines affect roughly 43% of women in the US and 18% of men, most commonly between the ages of 20-50. Global estimates are higher, with chronic migraines (CM) affecting 1% to 2% of the global population (that's between 78-156 million people!).
There are several possible triggers for migraines, including metabolic-based imbalances, musculoskeletal misalignment, the dysregulated firing of the nervous system, nutritional imbalances, and hormone imbalances.
Typical migraine treatments today can range anywhere from the more Western approach of botox and oral medications to Eastern or Somatic-based approaches including acupuncture and progressive muscle relaxation (PMR).
Functional Neurology, on the other hand, assesses for any imbalances that may exist within the systematic level of how our brains and bodies function, considering things like neuronal misfirings, stress, blood vessel dilation, blood-oxygen levels, brain waves, eye movements, nutrition, and more.
We were curious about what causes migraines from a cellular and systematic level, so we asked Dr. DeStephano from Chicago Neuro Chiropractic if she could clear up some questions for us, including what can trigger the headaches, what influences our susceptibility to them, and other important factors that we might not know about..yet.
The Interview
HC: Let's get into migraines! On a cellular and nervous system level, what is happening when a migraine occurs?
Dr. DeStephano: Migraines can be tricky and there is still much yet to be studied about them. On a cellular level, a migraine is vasoconstriction of blood vessels leading to the head. What causes this can vary from person to person, but generally it is due to neurological triggers. Migraines mainly affect women because one of the most common causes of this type of vasoconstriction is estrogen levels.
The most common demographic for migraines is women in childbearing years – where we see the most fluctuation in estrogen levels. Usually by menopause women no longer experience these migraines. Other hormone and neurotransmitter levels can stimulate this vasoconstriction and it also depends heavily on lifestyle and diet.
HC: Can blood-oxygen levels and nutrition affect a migraine?
Dr. DeStephano: Definitely. Low blood oxygen saturation can lead to vasoconstriction seen with migraines. One of our best tools to improve oxygenation in the blood is hyperbaric oxygen therapy.
The hyperbaric chamber increases the atmospheric pressure which forces more oxygen into the blood and directly into the tissues, which can cause vasodilation and bring more oxygen into the brain.
Nutrition plays a role in migraines as well. The majority of our hormones and neurotransmitters come from our gut, including the ones that stimulate vasoconstriction associated with migraines. So a healthy gut means regulation of these neurochemicals!
HC: What can trigger a migraine? Can they be hereditary or incited by trauma?
Dr. DeStephano: Certain foods can trigger migraines such as dark chocolate, red wine, cheese – basically all the good stuff. Migraines can be genetic, especially among women. Concussion patients can also experience migraine-like headaches. They usually aren’t triggered in the same way non-traumatic migraines are, but the presentation is similar (sensitivity to light and sound, sometimes an aura, headache over the eye on one side). However, migraines from concussions can’t usually be alleviated with migraine medication (and even some general migraines can’t be alleviated with migraine medication!). Bottom line is that migraines are different for just about everyone.
HC: What is your migraine treatment process like and how can a patient put in the work at home?
Dr. DeStephano: Hyperbaric is a great tool in our office for migraines. Increasing blood flow and oxygen to the brain helps to limit migraine occurrences. More oxygen to the body also just helps the body function better, which will help these patients as well.
We also use insufflation blubs for migraine patients. This technique delivers small, repeated puffs of air in the ear and onto the eardrum, which can relieve a patient of a migraine while it's occurring and can help stop it in its tracks.
Chiropractic adjustments are also beneficial in preventing migraines. Not only do cervical spine adjustments prevent tight muscles and keep the joints aligned, but it is also a great stimulus to the brain that helps gait pain. At home, we recommend patients avoid triggers and maintain a healthy diet and exercise.
HC: How much do you work with the eyes to reach the brain? Can you tell us more about that?
Dr. DeStephano: The eyes are one of our best windows into the brain! They are one of our main sources of assessment and treatment in functional neurology. Different eye movements are controlled by different parts of the brain, so doing a specific eye movement can help stimulate that area of the brain.
For example, our frontal lobe initiates our saccades or fast eye movements, but our cerebellum also gaits this action to make sure we move our eyes precisely to the target. Pursuits are controlled by the parietal lobe, but the vestibular system also helps this process. Convergence (eyes coming inward together/looking at something close) is a midbrain function, but the midbrain also controls our autonomic functions, so convergence and autonomic function are directly related. The list goes on!
For therapy, we can use these eye movements to stimulate those areas of the brain. Saccades are good for the frontal lobe, so a patient struggling with frontal lobe dysfunction, including depression/anxiety, lack of focus or concentration, poor memory, or decreased overall executive function, would benefit from doing saccade exercises. Convergence is good for autonomic function, so those exercises would benefit someone with anxiety, dysautonomia, POTS, or concussions. The best part is, these eye movements are good for just about every patient. Our brain is one big network; working on one area affects several others. One specific eye exercise actually helps the entire brain function better but will wake up some areas more directly than others.
We find what eye movements are efficient for finding what areas of the brain are deficient and need to be rehabbed. If we find saccades are poor, we know frontal lobe activation most likely will be beneficial, so treatment would include saccadic eye movements and other frontal lobe therapies such as transcranial magnetic stimulation (TMS), Alpha wave therapy, and brain games that require multi-tasking and decision making.
HC: What aspect of your work excites you the most or brings you the most fulfillment?
Dr. DeStephano: Watching people progressively get better over time. This type of treatment does not yield results as quickly as medication or surgery; it takes time to change the brain functionally.
We always tell patients at the beginning to give us about a month. After that first month, they should start to see something: better quality of sleep, more energy, better focus, less anxiety, and a general decrease in symptoms. They won’t be completely better in a month, but that small improvement at least tells me we are on the right path and that functional neurology can help them. Very rarely do patients not see anything after a month, but it has happened. In those cases, there is usually something else going on that requires other professional intervention. For the most part, people start to see small changes in their condition within that first month. That is honestly one of my favorite parts of this job. Watching people see themselves start to make improvements in a few short weeks. Even though there’s still much work to be done, it gives them hope.
A lot of people have never heard of functional neurology before seeing us, and often it is their last resort. Showing them this type of holistic, safe, functional, and EFFECTIVE method of neurological treatment is the most fulfilling aspect of this job. I love opening this new door to patients who have almost lost all hope.
HC: What is one topic you would like to bring to the forefront of the conversation in Functional Neurology?
Dr. DeStephano: We’ve been seeing a lot of post-COVID and COVID long-hauler patients over the last two years. Some people have had trouble shaking the symptoms and some have symptoms lasting for months after having the virus.
Symptoms usually include trouble catching their breath or feeling out of breath all the time, continued loss of smell and taste, brain fog including poor memory and focus, and excessive fatigue. Many people think there is nothing they can do for these lasting symptoms because COVID is still somewhat new to us, but functional neurology is a great place to start.
Viruses can attack our nervous system, which is usually the cause of prolonged symptoms. Rehabbing the nervous system can help your body shake the virus once and for all. Specifically, we’ve had a lot of success with COVID long haulers using our hyperbaric oxygen chambers.
Increasing the oxygen in our body helps our bodies to heal. Healing the body and brain helps with energy, immune health, and mental clarity. This influx of oxygen also helps these people breathe better. There is now more research out about the benefits of hyperbaric oxygen therapy and COVID long haul symptoms but most people still aren’t aware of it! I try my best to educate friends, family, and patients on the benefits of hyperbaric and functional neurology with COVID as much as I can.
I even had COVID last November and utilized hyperbaric and other functional neurology techniques to speed up my recovery. I even used eye movements and vagal stimulation to bring my smell and taste back! There is so much functional neurology can do for people and the most important part is that it’s SAFE. I hope functional neurology becomes more and more prevalent in the conversation about COVID in the near future.
HC: Can you share a particularly interesting success story with us?
Dr. DeStephano: I once had a dysautonomia patient who came to me in pretty bad shape. They had had a few concussions over the course of their life. They came in with a myriad of complaints including anxiety, poor sleep, gut issues, racing heart, and overheating.
After a few months of treatment, which included eye exercises, Gyrostim, TMS, neurofeedback, and more, they reported a significant decrease in anxiety, overall better quality of sleep, better digestion, and overheating rarely occurred.
The main target for treatment was regulating the autonomic nervous system. By doing that, the symptoms slowly started to disappear. This particular patient was also the best kind of patient you can have; they did all their home exercises and followed all the advice I gave them, which only sped up recovery. It was truly a success story because they really wanted to put in the time and effort to get better. I, as the doctor, can only do so much. A lot of it is on the patient to commit to treatment, which also includes putting in the effort at home and making lifestyle changes.
HC: Do supplements, detoxing, or medications ever interfere with the diagnosis or treatment process?
Dr. DeStephano: Supplements and detoxing usually do not affect diagnosis, and we recommend supplements to our patients all the time. Medication can affect diagnosis and treatments more, but it never gets in the way.
Many patients come to us on medication with the goal of weaning off, which has been very effective with functional neurology. Prescription medications such as antidepressants, anxiolytics, stimulants, etc., are not a solution to the problem and are not meant to be used for the long term. There is of course and time and a place for medication, and I am in no way against medication, but there is no reason someone should be on Prozac for 30 years.
As chiropractors, we cannot tell patients to decrease their dose of medication, but functional neurology helps them to become less dependent on it so they can talk with their primary care physician about lowering their dose and eventually stopping completely. We have successfully helped many patients get off medication they have relied on for years.
The whole point of functional neurology is to improve the function of the brain so that the patient does not need medication.
HC: For those interested in learning more about this topic, what resources would you suggest they explore? Books, podcasts, websites, organizations, YouTube channels, etc? Also, how can we get involved?
Dr. DeStephano: There are some great books for newcomers to functional neurology that may not have a deep neurology background but want to learn more. Some books that I’ve read and would recommend include:
I know there are many different neurology podcasts, but I am not a huge podcast person. The Carrick Institute has a podcast called Talk Neuro to Me which goes a little more in-depth into neurology, as they are the leaders in this field (fun fact: I did my functional neurology training through the Carrick Institute!)
There is also more and more buzz on functional neurology on social media than there was a few years ago. I often find a lot of easily accessible information through doctors on Instagram and Facebook that is very basic but aims to teach people about functional neurology who have never heard of it! I also try to keep our Instagram accessible to people who want to learn more by posting our different therapies and explaining how they benefit patients.
You can get involved by spreading the word! Chances are, you know someone who would benefit from functional neurology. Let them know this treatment option exists!
HC: Anything else you'd like to share?
Dr. DeStephano: While functional neurology is complex, it is also very simple. Your brain controls everything you do in life – if you don’t take care of it, life becomes harder. An optimal functioning brain means an optimal functioning YOU. There is no reason you need to keep living life at 60%. Take control of your health and start taking brain health seriously. Your mental health, gut, immune system, and soul will all thank you for it!
