Ann Arbor physician has spent more than 25 years developing
new strategies against headaches.
ALICE BURDICK SCHWEIGER
Special to the Jewish News
eurologist Joel Saper is known as the
He not only is one of the country's lead-
ing experts on migraine headaches, he is
founder of the Michigan Head Pain and Neurological
Institute in Ann Arbor, the nation's first comprehensive
head pain treatment and research center. This year, Dr.
Saper is marking his center's 25th anniversary.
"Years ago, headache was not considered a real
physical illness, rather a psychiatric disorder," says Dr.
Saper, who went to medical school at the University of
Illinois and did his residency at the University of
Michigan. "But over the years, we have learned a lot
more about headaches and have made great strides in
diagnosis and treatment."
Dr. Saper opened his center in 1978 with four
nurses and two psychologists. Today, the staff of 80
handles 24,000 patient visits a year from around the
world. Their hospital unit, at Chelsea Community
Hospital west of Ann Arbor, was the first in the world
for headache patients.
Some of the advances made in the past 25 years
include "about four times the number of medications,
both preventive and abortive, new diagnostic neuro-
imaging such as the MRI and PET scans, and behav-
ioral and self-help approaches to pain," says Dr. Saper.
"We also have immense advances in technological serv-
ices to help gain control over pain, including spinal
stimulators and neural blockade procedures to alter the
Dr. Joel Saper
pain carried in nerves."
Dr. Saper has collaborated on more than 100
research studies. He says of the new drugs, "There is
everything from the Tripans to anti-convulsants that
work on specific parts of the brain, and we have drugs
that reduce the nerve reactions in the neck."
Since 1978, researchers have identified some of the
changes in the brain that lead to headache. "We now
know it's a genetic disorder, not psychological, and
there are disturbances in the brain chemistry that are
responsible for headache," he says.
"While emotions can make it worse, most of the
mechanisms are biological. Still, stress, hormonal
changes, lack of sleep, bright lights, certain foods such
as cheese, chocolate, aged meat, alcohol, pickled foods,
aged meats and dairy products, can trigger a headache
in people who are prone."
According to Dr. William Leuchter, neurologist in
Southfield and associate professor of neurology at
Wayne State University School of Medicine in Detroit,
Dr. Saper has build a headache clinic that is interna-
tionally known and put Michigan on the map. "He is
a leading pioneer in the study of headache," says Dr.
"When he came on the horizon, there was no one
in the state of Michigan who was devoted solely to the
study of headache. Dr. Saper stimulated other neurolo-
gists, both in Michigan and around the country, to
become aware of headache as a distinct entity that
required aggressive treatment. He developed a multi-
disciplinary approach that doesn't only deal with
medication, but involves the psychological and phar-
macological aspects as well as pain management."
Dr. Saper's interest in migraines began when he
was an assistant professor of neurology at U-M. "I
began to see some people in extreme pain who were
told it was all in their head," says Dr. Saper. "I felt
these people, who were told it was emotional, had
legitimate pain and I wanted to help them and I was
given a research grant.
"Some of my work was written up in the Detroit
Free Press and went out on the wire services, and I
started to get calls from people all over the United
States. So I followed that demand and began to set
up a small program at U-M and published my first
book. In 1978, I decided to develop the center."
It features two waiting rooms — one lighted and
one darkened — and dimly lit hallways. Smoking and
perfurnes have been banned since the center opened in
His was the first comprehensive headache program
in the world, providing for a array of services and treat-
ments. Chelsea was the first hospital program for
severe headache sufferers, utilizing neurologists,
internists, anesthesiologists, physical therapists, psy-
chologists and physician assistants and nurses.
ATTACKING MIGRAINES on page 73