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18 hours 49 min

Association of dietary diversity score (DDS) and migraine headache severity among women

Association of dietary diversity score (DDS) and migraine headache severity among women

Migraine is an episodic disorder that is characterized by unilateral headache lasting 4-72 h along with certain associated features. Modifying dietary habits have been considered an appropriate therapeutic approach in ..... see more

Source : https://link.springer.com/article/10.1007/s10072-020-04982-6

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18 hours 50 min

Headache characteristics and burden from chronic migraine with medication overuse headache: Cross-sectional observations from the Medication Overuse Treatment Strategy trial - PubMed

Headache characteristics and burden from chronic migraine with medication overuse headache: Cross-sectional observations from the Medication Overuse Treatment Strategy trial - PubMed

doi: 10.1111/head.14056. Online ahead of print. 1 Department of Neurology, Mayo Clinic, Phoenix, AZ, USA. 2 Department of Neurology, University of Southern California, Los Angeles, CA, USA. 3 Department of ..... see more

Source : https://pubmed.ncbi.nlm.nih.gov/33432635/

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18 hours 50 min

Association of lipid profile in migraine and non- migraine patients: an observational study

Association of lipid profile in migraine and non- migraine patients: an observational study

Anchal Bana Post Graduate Student, Department Of Ophthalmology, Muzaffarnagar Medical College, Muzaffarnagar, U.P, India Suman Bhartiya Professor and Head, Department Of Ophthalmology, Muzaffarnagar Medical College, Muzaffarnagar, U.P , India. Prachi ..... see more

Source : https://www.ijhcr.com/index.php/ijhcr/article/view/516

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18 hours 57 min

Chronic migraine: Genetics or environment? - PubMed

Chronic migraine: Genetics or environment? - PubMed

doi: 10.1111/ene.14724. Online ahead of print. 1 Department of Neurology, Danish Headache Center, Copenhagen University Hospital, Glostrup, Denmark. 2 Novo Nordic Foundation Center for Protein Research, Copenhagen University, Copenhagen, Denmark. ..... see more

Source : https://pubmed.ncbi.nlm.nih.gov/33428804/

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1 day 19 hours

Occipital Neuralgia Pain in the Back of the Head, Treatments, and Block

Occipital Neuralgia Pain in the Back of the Head, Treatments, and Block

WHAT A PAIN IN THE BACK OF THE HEAD! OCCIPITAL NEURALGIA, TREATMENTS, AND TECHNIQUE FOR OCCIPITAL NERVE BLOCK. @Neuralgroover Background Occipital neuralgia is a miserable nagging soreness and pain in ..... see more

Source : https://virtualheadachespecialist.com/pain-in-the-back-of-the-head-occipital-neuralgia-treatments-and-occipital-nerve-block/

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1 day 19 hours

Syncope episode, syncope definition, and syncope causes.

Syncope episode, syncope definition, and syncope causes.

SYNCOPE EPISODE, SYNCOPE DEFINITION, AND AN EASY TOOL TO QUICKLY RECALL ALL CAUSES OF SYNCOPE. @Neuralgroover If you have ever had a syncope episode (passing out, or fainting), you know ..... see more

Source : https://virtualheadachespecialist.com/syncope-episode-syncope-definition-and-syncope-causes/

matthew shore from Doctor Unite, William DeMedio from Doctor Unite Commented on a Post
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Episodic and Chronic Migraine Treatment during the COVID-19 Pandemic

COVID-19 has made it necessary for clinicians to adapt how they diagnose, treat, and manage patients with chronic diseases, including migraine. With lockdowns and patients concerns about leaving their homes, telemedicine and the availability of efficacious self-administered therapies, such as subcutaneous prophylactic CGRPs, have facilitated the continued care of migraineurs.

Initiation of prophylactic CGRPs is typically prescribed for migraineurs with 4+ migraine days per month who have failed 2+ oral therapies However, since the COVID-19 pandemic, migraine treatment decisions have likely changed due to Botox injection cancellations, potential SARS-CoV-2 infections, increased anxiety or headache triggers, and putative links between the use of certain drugs, such as angiotensin‐converting enzyme (ACE) inhibitors/angiotensin receptor blockers (ARBs), and increased COVID-19 infection risk1. (I would delete this portion because it relates to hospitalized COVID-19 patients)

How has the COVID-19 pandemic impacted your prescribing decisions regarding the initiation of prophylactic CGRP therapy in episodic and chronic migraine patients? What are the factors that contribute to treatment selection during the pandemic?

1 https://www.acc.org/latest-in-cardiology/articles/2020/03/17/08/59/hfsa-acc-aha-statement-addresses-concerns-re-using-raas-antagonists-in-covid-19
 

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  • from Doctor Unite 2 days 20 hours
    More telemedicine but I’m still prescribing these medications
  • from Doctor Unite 2 days 20 hours
    The epidemic has not affected my ability to prescribe CGRP inhibitors. When deemed necessary, there is a fairly involved preapproval process required to get these meds covered by insurance which Show More
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What Comes Next: A Patient Case With Preventive Migraine Treatment

Sam suffers from 8 migraine days/month, interfering with work and family life. She tried propranolol 80 mg/day for 2 months but her migraine did not improve. She then tried topiramate 100 mg/day for 3 months, but she still has 6 migraine days/month (at least one migraine day per week). How would you proceed?

Total votes: 50

Sam's HCP has determined that she is failing on her current treatment. While Sam's HCP could either titrate her dose or try another oral therapy, she has other options. According to the American Headache Society, she qualifies for an anti-CGRP mAb preventive therapy because two oral migraine preventive medications have already failed.1 Among patients with EM who qualify for anti-CGRP preventive therapy, like Sam, only 7.9% are actually receiving it.1,2

 

References:
1. American Headache Society. Headache. 2019;59(1):1-18.
2. Data on file, Amgen. [IQVIA LAAD (Paid Claims) Data; May 2019 through April 2020].

USA-334-84117 8/20

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  • 1 month
    I would increase the Topamax at the recommended dose but also try to help pt identify triggers to the headaches, she may also benefit from an allergist however difficult to Show More
  • 1 month
    cGRP is a good choice as long as she is not planning pregnancy. looking at lifestyle changes, like focusing on sleep and stress issues as well as trigger control Show More
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1 week

Coenzyme Q10 supplementation for prophylaxis in adult patients with migraine—a meta-analysis

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Source : https://bmjopen.bmj.com/content/bmjopen/11/1/e039358.full.pdf

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  • 5 days 21 hours
    This is a really informative study, since many patients do prefer natural supplements and not prescribed medications as an alternative for their headaches.
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1 week

A trial of antithrombotic therapy in patients with refractory migraine and antiphospholipid antibodies: A retrospective study of 75 patients.

A trial of antithrombotic therapy in patients with refractory migraine and antiphospholipid antibodies: A retrospective study of 75 patients.

OBJECTIVE: It has been reported that patients with antiphospholipid antibodies (aPL) and refractory migraine may experience symptomatic improvement with antithrombotic therapy, but this phenomenon has not been well studied. This ..... see more

Source : https://read.qxmd.com/read/33402037/a-trial-of-antithrombotic-therapy-in-patients-with-refractory-migraine-and-antiphospholipid-antibodies-a-retrospective-study-of-75-patients

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  • 5 days 21 hours
    It is possible that there is a level of microthrombi causing migraine in these patients. Will need more follow up studies.
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6 days 22 hours

Feasibility of using "SMARTER" methodology for monitoring precipitating conditions of pediatric migraine episodes - PubMed

Feasibility of using "SMARTER" methodology for monitoring precipitating conditions of pediatric migraine episodes - PubMed

A contemporary data sampling approach comprising ambulatory sensors and real-time reporting appears to be acceptable to most youth with migraine in this study. Reliability of acquiring some data sources from ..... see more

Source : https://pubmed.ncbi.nlm.nih.gov/33382086/

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  • 5 days 21 hours
    It is clear that this will be the new way to gather data on real patient disease, we have to find better and more effective ways so that we can Show More
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6 days 22 hours

Differential alteration of fMRI signal variability in the ascending trigeminal somatosensory and pain modulatory pathways in migraine - PubMed

Differential alteration of fMRI signal variability in the ascending trigeminal somatosensory and pain modulatory pathways in migraine - PubMed

doi: 10.1186/s10194-020-01210-6. 1 Headache and Orofacial Pain Effort (H.O.P.E.), Department of Biologic and Materials Sciences & Prosthodontics, University of Michigan School of Dentistry, 1011 N. University Ave, Room 1014A, Ann ..... see more

Source : https://pubmed.ncbi.nlm.nih.gov/33413090/

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  • 5 days 21 hours
    This is an interesting study showing that there are regional differences in the brain pathways involved in migraine pathophysiology. This may be helpful in the future for ways to Show More
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2 weeks

Open Label Prospective Experience of Supplementation with a Fixed Combination of Magnesium, Vitamin B2, Feverfew, Andrographis Paniculata and Coenzyme Q10 for Episodic Migraine Prophylaxis

Open Label Prospective Experience of Supplementation with a Fixed Combination of Magnesium, Vitamin B2, Feverfew, Andrographis Paniculata and Coenzyme Q10 for Episodic Migraine Prophylaxis

Background: To investigate the efficacy and safety of supplementation with a fixed combination of magnesium, vitamin B2, feverfew, andrographis paniculata and coenzyme Q10 in episodic migraine (EM) prevention. Methods: A ..... see more

Source : https://www.mdpi.com/2077-0383/10/1/67/htm

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  • 1 week 3 days
    I use magnesium, 200-400 mg daily, a B-100 Complex 3 days a week , Vitamin D3 2,000 units daily, Tumeric 3 days a week, selenium 3 days a week, and Show More
  • 1 week 5 days
    This is a good study that gives some insight into natural supplements for migraine, since so many patients like to use natural supplements instead of prescription medications.
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4 weeks

Are Methods for Evaluating Medications Appropriate for Evaluating Nonpharmacological Treatments for Pain?—Challenges for an Emerging Field of Research

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Source : https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2774121

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  • 1 week 5 days
    It is important to pick the right outcomes when evaluating different types of treatment options in migraine since there is such a diversity in symptoms and treatment modailities.
  • 2 weeks 1 day
    This is an editorial regarding a randomized blinded trial of mindfulness based stress reduction (MBSR) in migraine. I would recommend reviewing the actual article:JAMA Intern Med. doi:10.1001/jamainternmed.2020.7090 Published online December Show More
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4 weeks

Cognitive and emotional impairment in patients with migraine and signs of leukoencephalopathy during preventive therapy | Pozhidaev | Neurology, Neuropsychiatry, Psychosomatics

Cognitive and emotional impairment in patients with migraine and signs of leukoencephalopathy during preventive therapy | Pozhidaev | Neurology, Neuropsychiatry, Psychosomatics

1. Stovner LJ, Hagen K, Jensen R, et al. The global burden of headache: a documentation of headache prevalence and disability worldwide. Cephalalgia. 2007 Mar;27(3):193- 210. doi: 10.1111/j.1468-2982.2007.01288.x 2. Vos ..... see more

Source : https://nnp.ima-press.net/nnp/article/view/1467

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  • 2 weeks 1 day
    Interesting study suggesting that those with migraine, especially chronic migraine have both cognitive deficits (subtle) and emotional issues; both of which improve with effective treatment of migraine. Improvement in Show More
  • 2 weeks 5 days
    This is a very interesting study that highlights the fact that migraine is more than just a headache. There are objective measurable cognitive impairment that can come with it, Show More
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4 weeks

Hypersensitivity to Calcitonin Gene-Related Peptide in Post-Traumatic Headache - PubMed

Hypersensitivity to Calcitonin Gene-Related Peptide in Post-Traumatic Headache - PubMed

Objective: To demonstrate that calcitonin gene-related peptide (CGRP) induces headache exacerbation with migraine-like features in patients with persistent post-traumatic headache (PTH) attributed to mild traumatic brain injury (TBI). Methods: A ..... see more

Source : https://pubmed.ncbi.nlm.nih.gov/32959458/

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  • 2 weeks 1 day
    Agree, interesting article which may support that the phenotype of the headache ie migraine may be more important than the cause (mTBI) with regard to mechanism and treatment. 2 Show More
  • 2 weeks 5 days
    This is a really helpful study as it can provide evidence that cGRP inhibitors may be helpful in the treatment of PTH.
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1 month 1 week

34-year-old female presents with chronic migraine

History of present illness: The 34-year-old patient reports feeling overwhelmed lately, and notes that according to her headache journal, she spends over seventeen ..... see more

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  • from Generation NP 4 weeks 1 day
    I would review her records and see what work up she has had in the past with an update on her labs and make sure her thyroid function is ok. Show More
  • 4 weeks 1 day
    I think the 50% benchmark is there because that is what is used in studies to be considered a successful trial. I understand that people do not have headaches Show More
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1 month

Don't allow chronic migraine and pain to define you and your plasticity.

Don't allow chronic migraine and pain to define you and your plasticity.

STOP LETTING YOUR CHRONIC MIGRAINE AND CHRONIC PAIN DEFINE YOU AND YOUR BRAIN PLASTICITY. @Neuralgroover Background I see the worst of the worst headache, migraine, chronic migraine, facial pain, fibromyalgia, ..... see more

Source : https://virtualheadachespecialist.com/chronic-migraine-chronic-pain-and-brain-plasticity/

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  • 4 weeks 1 day
    This is an important piece exploring the complex issue of chronic pain.
  • 1 month
    This is a very empowering piece for patients who struggle with chronic pain including migraine! I very much like the idea of having the patient in control of their Show More
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1 month

Botox for chronic migraine, the most effective pattern and technique.

Botox for chronic migraine, the most effective pattern and technique.

BOTOX (OnabotulinumtoxinA) FOR CHRONIC MIGRAINE; THE MOST EFFECTIVE PATTERN, TECHNIQUE, AND EVERYTHING YOU NEED TO KNOW. NOT ALL BOTOX TREATMENTS ARE CREATED EQUAL. @Neuralgroover Background Botox (Onabotulinum Toxin A) has ..... see more

Source : https://virtualheadachespecialist.com/botox-onabotulinumtoxina-for-chronic-migraine-optimizing-technique/

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  • 4 weeks 1 day
    The above comments are really helpful. Some patients want to stop due to the side effects or not seeing any benefit immediately after the first injection. Educating the Show More
  • 1 month
    Very informative. A few comments: 1. adjusting the injection sites "follow the pain" is often helpful but I have not found that there is one standard paradigm for injections that Show More
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1 month

Acute treatment of migraine in children and adolescents: review of the American Academy of Neurology Practice guideline update

Acute treatment of migraine in children and adolescents: review of the American Academy of Neurology Practice guideline update

Migraine is a brain disease that involves episodes of medium to severe headaches along with specific associated symptoms, including nausea, vomiting, photophobia and phonophobia, as defined by criteria developed by ..... see more

Source : https://ep.bmj.com/content/early/2020/12/08/archdischild-2019-318580

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  • 1 month
    Here is a link to the full article that has free access: https://n.neurology.org/content/93/11/487
  • 1 month
    This is a really good review article about all the known evidence regarding treating migraine in children.