Elliot Shevel
Encyclopedia
Elliot Shevel BDS
, DipMFOS, MBBCh (born January 03, 1943 (age 69)) is a South Africa
n Maxillo-Facial and Oral Surgeon
, best known for his contribution to understanding of the underlying processes involved in the pain of migraine
. He is, inter alia
, a tireless campaigner to have the work of Harold Wolff, which many migraine researchers have sought to discredit, understood and accepted. Although Wolff and his co-workers showed conclusively in the 1940s that the terminal branches of the external carotid artery
are a source of pain in migraine, his work has been forgotten, and most migraine researchers today are unaware of the importance of Wolff’s work. Shevel maintains that progress in the understanding of migraine pain has been materially retarded by this, and has published a number of papers on the subject.
.
His first contribution to medical science was the development of an atraumatic method of removing impacted wisdom teeth, which significantly reduces the amount of post-operative swelling and pain.
.
throbbed visibly during a migraine attack. Digital compression of this artery sometimes resulted in the pain being reduced or eliminated while the pressure was maintained. When the pressure was removed, the pain returned. As a Maxillo-Facial Surgeon, he knew that this vessel could be tied off without any untoward side effects. Encouraged by the results of the surgery, he decided to publish a description of the procedure. At that stage, Shevel was unaware of the work of Harold Wolff, but when he studied the published literature, he was astounded to find that the involvement of the extracranial terminal branches of the external carotid artery in migraine pain had been recognized and proven by Wolff as long ago as 1934. Wolff’s theory has since been confirmed many times.
. The results of surgical cauterization in selected patients were excellent, particularly as all the patients undergoing the surgery were suffering from ‘refractory migraine’ – migraine that had not responded to any other form of treatment.
A search of the literature brought to light a number of previously published published papers describing either ligation
or cryotherapeutic ablation
of the terminal branches of the external carotid artery for migraine and migraine-like headaches. The first mention in the literature of arterial migraine surgery
was by Abu Quasim al Zahrawi, the personal physician to King Hassan of Spain
(936-1013). Since then there have been numerous reports of this procedure from many countries, but they have been largely unnoticed or ignored by mainstream headache scientists. Painful dilatation of the extracranial terminal branches of the external carotid artery is not a diagnostic criterion for migraine in the International Headache Classification, and most headache specialists are unaware that is an important component of migraine pain. On the contrary, some have, notwithstanding the evidence, made a concerted attempt to discredit Wolff’s findings, even though no one has been able to provide evidence that disproves Wolff’s theory. Shevel has devoted himself to resuscitating Wolff’s ideas, and to this end has published a number of articles in peer-reviewed medical journals. and writes a constant stream of letters to the editors of the important headache journals.
Dental degree
There are a number of first professional degrees in dentistry offered by schools in various countries around the world. These include the following:* Doctor of Dental Surgery * Doctor of Dental Medicine * Bachelor of Dentistry...
, DipMFOS, MBBCh (born January 03, 1943 (age 69)) is a South Africa
South Africa
The Republic of South Africa is a country in southern Africa. Located at the southern tip of Africa, it is divided into nine provinces, with of coastline on the Atlantic and Indian oceans...
n Maxillo-Facial and Oral Surgeon
Surgeon
In medicine, a surgeon is a specialist in surgery. Surgery is a broad category of invasive medical treatment that involves the cutting of a body, whether human or animal, for a specific reason such as the removal of diseased tissue or to repair a tear or breakage...
, best known for his contribution to understanding of the underlying processes involved in the pain of migraine
Migraine
Migraine is a chronic neurological disorder characterized by moderate to severe headaches, and nausea...
. He is, inter alia
Inter Alia
-Track listing:# Inter Alia# Outfox'd # Righteous Badass # The Altogether feat. Bix, Apt, UNIVERSE ARM and Cal# The Day-to-Daily# Trouble Brewing # The Prestidigitator# The Force...
, a tireless campaigner to have the work of Harold Wolff, which many migraine researchers have sought to discredit, understood and accepted. Although Wolff and his co-workers showed conclusively in the 1940s that the terminal branches of the external carotid artery
External carotid artery
In human anatomy, the external carotid artery is a major artery of the head and neck. It arises from the common carotid artery when it bifurcates into the external and internal carotid artery.-Course:...
are a source of pain in migraine, his work has been forgotten, and most migraine researchers today are unaware of the importance of Wolff’s work. Shevel maintains that progress in the understanding of migraine pain has been materially retarded by this, and has published a number of papers on the subject.
Career
Shevel has practised as a Maxillo-Facial and Oral Surgeon in Johannesburg, South Africa, since 1973. In 1999 he was awarded an honorary fellowship by the International College of Craniomandibular Orthopedics, and he is a peer reviewer for "The European Journal of Neurology", the "Medical Science Monitor", the "International Journal of Clinical Practice", and "Headache", the official journal of the American Headache SocietyAmerican Headache Society
The American Headache Society is a professional society of health care providers dedicated to the study and treatment of headache and facial pain....
.
His first contribution to medical science was the development of an atraumatic method of removing impacted wisdom teeth, which significantly reduces the amount of post-operative swelling and pain.
Muscles and migraine pain
In 1992, he developed an intra-oral appliance (called the Posture Modifying Appliance or PMA) for the treatment of the myofascial pain dysfunction syndrome (MPDS). When some of his patients reported that wearing the PMA had reduced or eliminated their migraines, he realized that there must be a muscle tension component to the pain of migraine. This was confirmed in a literature search, which revealed that the presence of pericranial muscle tenderness in migraine had been extensively documented, and that there is focal pericranial (masticatory and cervical) muscle tenderness with associated referred symptoms that reproduce the headache pain. As the migraine headache increases in intensity, there is increasing tenderness of the pericranial muscles. The literature search also revealed that various intra-oral appliances designed to reduce muscle tension, are effective in the treatment of migraine. Shevel started restricting his practice to the treatment of migraine and tension-type headaches. The results of muscle tension treatment with the PMA for tension-type headache and for the muscle tension component of migraine are excellent, particularly as the medication with its side-effects is eliminated or reduced in successfully treated migraineurs. Although the treatment of muscle tension has been shown to be effective in some migraine sufferers, this form of treatment has not been recognized by the vast majority of migraine specialists, and muscle pain is not listed as a symptom of migraine in the official headache classification of the International Headache SocietyInternational Headache Society
The International Headache Society is a charity organization founded in 1981 for people from all professions that are working to treat headache disorders....
.
Arteries and migraine pain
In 1995, Shevel observed that in some migraine patients the frontal branch of the superficial temporal arterySuperficial temporal artery
In human anatomy, the superficial temporal artery is a major artery of the head. It arises from the external carotid artery when it bifurcates into the superficial temporal artery and maxillary artery....
throbbed visibly during a migraine attack. Digital compression of this artery sometimes resulted in the pain being reduced or eliminated while the pressure was maintained. When the pressure was removed, the pain returned. As a Maxillo-Facial Surgeon, he knew that this vessel could be tied off without any untoward side effects. Encouraged by the results of the surgery, he decided to publish a description of the procedure. At that stage, Shevel was unaware of the work of Harold Wolff, but when he studied the published literature, he was astounded to find that the involvement of the extracranial terminal branches of the external carotid artery in migraine pain had been recognized and proven by Wolff as long ago as 1934. Wolff’s theory has since been confirmed many times.
Arterial surgery for migraine
Armed with this knowledge, he developed a protocol for the identification of the painful vessels, and their surgical cauterizationCauterization
The medical practice or technique of cauterization is the burning of part of a body to remove or close off a part of it in a process called cautery, which destroys some tissue, in an attempt to mitigate damage, remove an undesired growth, or minimize other potential medical harmful possibilities...
. The results of surgical cauterization in selected patients were excellent, particularly as all the patients undergoing the surgery were suffering from ‘refractory migraine’ – migraine that had not responded to any other form of treatment.
A search of the literature brought to light a number of previously published published papers describing either ligation
Ligation
Ligation may refer to:* In molecular biology, the covalent linking of two ends of DNA molecules using DNA ligase* In medicine, the making of a ligature * Chemical ligation, the production of peptides from amino acids...
or cryotherapeutic ablation
Ablation
Ablation is removal of material from the surface of an object by vaporization, chipping, or other erosive processes. This occurs in spaceflight during ascent and atmospheric reentry, glaciology, medicine, and passive fire protection.-Spaceflight:...
of the terminal branches of the external carotid artery for migraine and migraine-like headaches. The first mention in the literature of arterial migraine surgery
Migraine surgery
Migraine surgery is any surgical operation undertaken with the goal of reducing or preventing migraines. Innovative surgical techniques have been developed to help patients with migraine headaches. Migraines affect an estimated 10% of the worldwide population annually and cause significant loss of...
was by Abu Quasim al Zahrawi, the personal physician to King Hassan of Spain
Spain
Spain , officially the Kingdom of Spain languages]] under the European Charter for Regional or Minority Languages. In each of these, Spain's official name is as follows:;;;;;;), is a country and member state of the European Union located in southwestern Europe on the Iberian Peninsula...
(936-1013). Since then there have been numerous reports of this procedure from many countries, but they have been largely unnoticed or ignored by mainstream headache scientists. Painful dilatation of the extracranial terminal branches of the external carotid artery is not a diagnostic criterion for migraine in the International Headache Classification, and most headache specialists are unaware that is an important component of migraine pain. On the contrary, some have, notwithstanding the evidence, made a concerted attempt to discredit Wolff’s findings, even though no one has been able to provide evidence that disproves Wolff’s theory. Shevel has devoted himself to resuscitating Wolff’s ideas, and to this end has published a number of articles in peer-reviewed medical journals. and writes a constant stream of letters to the editors of the important headache journals.