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    I just evaluated a 40 yo female patient with a seizure disorder. She came in for coccyx pain and urinary incontinence but she is also struggling with a severe increase in migraines after hitting her head 2x during a cluster of seizures 3 years ago. Assessment of her cervical spine revealed upper cervical dysfunction and I strongly believe that dry needling and manual therapy to this area would be effective to address her migraines. I rarely work with people with seizure history and wondering if there is any issues with dry needling this population? I am going to call her neurologist to discuss this intervention option prior to using it on the patient as this was not why she was referred to me and I don’t have a relationship with her neurologist. Thank you for any input/feedback!


    Hi Jackie,
    The obvious issue is having in situ needles when she could have a seizure so I would always do an in / out procedure and incorporate some rotation to get the dosage. The second issue is will DN trigger a seizure? I can not provide a definitive answer on that, but the issues she is coming to you for warrant a trial of DN as it would be effective for those. I think you are correct in calling the neurologist and keeping the discussion to the musculoskeletal complaints you are using the DN to correct. The in / out technique will be safe and I have never had DN trigger a seizure in patients presenting like you describe using this technique.

    Hope that helps


    Great. Thank you so much for your feedback!

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