#122 Headaches Advanced Class
Published October 29, 2018
78 min
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    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.


    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


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