#122 Headaches Advanced Class

The Curbsiders Internal Medicine Podcast

Health & Fitness, Medicine, Science, Higher Education, Education

4.8 • 3.1K Ratings

🗓️ 29 October 2018

⏱️ 78 minutes

🔗️ Recording | iTunes | RSS

🧾️ Download transcript

Summary

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 [email protected].

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

Transcript

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0:00.0	The first cyber-block has been for entertainment education and information process only.
0:09.2	And the topics discussed should not be used only by industry,
0:10.7	you're ordinary and in these ordinary conditions.
0:12.0	But more than you would say it's expressed on the cyber-block has been so low to those,
0:13.7	should not be interpreted perfectly for official policy,
0:14.8	or for the should of any entity, the cyber-phosphate,
0:16.0	cash-like morons will end up in the outreach programs,
0:17.4	and indeed there are any in fact there are none.
0:18.9	Pretty much we are responsible for this throughout,
0:19.9	but we should always do our homework and let's know when we're ready.
0:21.3	Welcome back to the Curbsiders.
0:37.1	Well, hi Paul.
0:38.5	Hi Stewart.
0:40.1	Hey, how you doing?
0:41.3	Good, you guys are both here.
0:42.6	I was worried that I was recording by myself again.
0:45.3	So this is Dr. Matthew Wato as you heard.
0:49.0	I'm with Paul and Stewart here.
0:50.5	And Paul, did you want to remind the audience what we do on this show?
0:56.4	Well Paul would be telling us what the show is about,
0:58.2	but his connection just cut out and it's late,
1:00.2	so we're just going to get to it.
	...

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