Longtime neurologist opens Mitchell clinic after brief hiatus, providing research-backed migraine treatments

MITCHELL — Tucked in the basement of Krall Eye Clinic, a well-known South Dakota neurologist has been providing patients suffering from migraines and headaches with breakthrough treatments over the past eight months.

After spending over two decades as a practicing neurologist based out of Sioux Falls, Dr. Carol Nelson found a new spot for her clinic in the basement of a Mitchell building where her longtime research partner and Mitchell eye doctor, Jeff Krall, works.

Although she had plans to retire over a year ago following her departure from Avera Health in Sioux Falls, Nelson’s passion for neurology guided her back to the field in September. Only this time, the neurologist opened her own practice in Mitchell rather than working under a health care system.

“I was going to retire, but I just love neurology. There is a big shortage of neurologists. I really love what I do, and I really love doing headache management,” Nelson said of her passion for the field. “I wanted to go back to the way medicine used to be practiced where there’s not so many people between the patient and the doctor.”

Nelson specializes in headache and migraine management and utilizes a variety of treatment methods she’s spent years researching.

In her 28 years as a practicing neurologist and researcher, Nelson said botox treatment stands out as one of the key breakthroughs in migraine and headache research. And she’s been using it to successfully treat migraine headaches for some of her patients.

“They started injecting botox for wrinkles on the forehead for cosmetic reasons, people reported their headaches were starting to get better. Then we started researching it and found the best places to put it,” Nelson said of the botox research that led to breakthrough treatments of migraines and headaches. “When I do it, it’s 31 injections with tiny little needles. What we’ve found is that it’s not just relaxing the muscle, it actually changes the chemical in your brain so you don’t get headaches.”

When Nelson began her residency in the early 1990s, the science behind treating headaches and migraines was nowhere near the level it is today, she said. Nelson still recalls her early years of practicing when over the counter medications like Tylenol and Benadryl were used as treatments for headache problems.

It wasn’t until 1998 that she began using botox as a form of treatment, which took off a decade later when the Food and Drug Administration approved it for migraine treatment. Another treatment that she considers a breakthrough medication for migraines are triptans, which help tamper down overactive nerves in the brain.

“In 2010, insurance could cover botox. It was a huge leap. This is why money is needed for research. This is also why we need more people to go to medical school,” Nelson said. “It’s a fascinating field, and we need people who can revolutionize things and make them better. There’s still advancements to be made.”

While it’s unknown what exactly causes migraines, Nelson said blue light exposure from electronic screens like mobile phones and computers can intensify migraines and headaches.

According to Nelson, the criteria to diagnose a migraine includes throbbing of the head, one-sided headaches, nausea, light sensitivity, sound sensitivity, headaches that gradually intensify with activity and severe headaches.

“Experiencing just three of those is considered a migraine. Most of them do get severe, but if they are not they can still be a migraine that needs to be treated,” Nelson said.

When Nelson began diving into the research side of brain neurology over two decades ago, she crossed paths with Krall.

At that time, Krall was focusing his research on neurolenses, which are innovative glasses designed to relieve headaches, neck pain and eye fatigue. After spending many years researching neurology together, Nelson and Krall developed a strong working relationship with a mission to advance brain science.

“He and I – because we both do a lot of headache things – started working and researching together in 2011,” she said of Krall.

Although Nelson resides in Sioux Falls, she was bound by a restrictive covenant that prohibited her from opening a private practice within 50 miles of the Sioux Falls clinic she previously worked at. The restrictive covenant wasn’t the only reason she decided to choose Mitchell, however. Her strong working relationship with Krall and the layout of the lower floor of the Krall Eye Clinic building were key factors behind her decision to open a practice in Mitchell.

“The important part for Mitchell is that I’m not just going to stay here for two years. I’m staying here until I’m done,” she said of her future plans to practice in Mitchell.