Headache and POTS: Migraine, Joint Hypermobility & CSF Leaks

Dr. Laurence Kinsella from the SSM Neurosciences Institute discusses the potential connection between CSF leaks and headaches in patients with POTS, particularly those with joint hypermobility or EDS. He notes that many POTS patients experience headaches and often have comorbid EDS, which might predispose them to spontaneous CSF leaks due to connective tissue fragility. However, he also points out that postural headaches, common in POTS, do not always result from CSF leaks, and other causes such as migraine should be considered. Dr. Kinsella suggests that a trial of epidural blood patching might help some patients with postural headaches despite no confirmed leak. The lecture underscores the need for individualized treatment plans that might include both pharmacological and nonpharmacological approaches, depending on the patient's unique profile and symptoms.