We delve into advanced management of headaches, including novel therapies, migraines with aura, migraines in complicated patients, and headaches of short duration with Dr. Rebecca Burch, a headache medicine specialist at the John R. Graham Headache Center at Brigham and Women’s Hospital.
Full show notes available at http://thecurbsiders.com/podcast. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.
Credits
Written and produced by: Paul Williams MD
Edited by: Matthew Watto MD
Hosts: Paul Williams MD, Stuart Brigham MD, Matthew Watto MD
Guest: Rebecca Burch MD
Time Stamps
- 00:00 Disclaimer, intro and guest bio
- 03:28 Guest one-liner, movie and podcast recommendations, favorite failure and picks of the week from The Curbsiders
- 10:38 Clinical case of migraines; diagnosis and classification
- 14:12 Does medication overuse headache exist?
- 16:16 Chronic daily headache; Conversion from episodic to chronic and vice versa
- 21:43 Approaches to medication overuse headache
- 25:54 Case 2: migraine with aura and other types of migraine (retinal, hemiplegic, etc.)
- 32:09 Pathophysiology of migraine; how triptans work; How should aura effect management?
- 38:44 Migraine cocktails
- 41:15 Comorbid mood disorders; Use of psych meds and triptans
- 45:08 Migraines and oral contraceptives
- 48:42 Botulinum toxin and new CGRP therapies
- 53:36 What does success look like in migraine therapy?
- 55:32 Nonpharmacologic management
- 60:45 Case 3: headaches of short duration
- 66:36 Headache red flags; Imaging for headaches; pathophysiology of high and low pressure headaches
- 72:00 Idiopathic intracranial hypertension
- 75:25 Take home points
- 77:00 Outro