Update on Botox for teens under 18
I did my first post about Botox for teens under 18 in July 2019, 3 years ago! My intention was to review our data and prepare for publication a paper supporting the use of Botox for those under age 18. The more academic publications there are available, the better to make the case with insurance … Continue reading Update on Botox for teens under 18
Revisiting the ‘new’ migraine prevention medications
When I first covered the anti-CGRP medications, it was 2019, just 1 year after they had come out. Since then, we have much gained more exposure to these medications, though none are approved by the FDA for those under age 18 yet. We get asked all the time about these medications, and while they do … Continue reading Revisiting the ‘new’ migraine prevention medications
Revisiting pediatric migraine: preventive medications, part 1
In this post, I revisit the prescribing a daily medication for migraine prophylaxis, the standard medications for those under age 18. I use one migraine/week as a benchmark for considering a daily preventive medication. Here’s some good information on the basic daily medications that pediatric primary care providers could start for their patients with frequent … Continue reading Revisiting pediatric migraine: preventive medications, part 1
Revisiting migraine: supplements
Primary preventive measures to reduce migraine, such as the healthy headache lifestyle, are key to keeping migraine frequency to a minimum. But even though your patient is really working hard with the multidisciplinary approach, your patient is still having frequent migraines which significantly impact their functioning. When do you consider adding a daily medication to … Continue reading Revisiting migraine: supplements
Revisiting migraines part 4: adjuvant medications and combination therapies
My last posts have focused on migraine abortives and analgesia for kids with migraine. Here I will continue to review medications and strategies for rescue, focusing on adjuvants and combination medications. These medications are the 3rd leg of the plan which are used to treat migraine. . There are several medications that are used either … Continue reading Revisiting migraines part 4: adjuvant medications and combination therapies
Revisiting migraines part 3: analgesia
My last post focused on the migraine abortive medications for kids with migraine. Here I will continue to review medications and strategies for rescue, focusing on analgesia. There are 3 different types of medications that are important in migraine rescue therapy: migraine abortive, analgesia, and adjuncts. Analgesic medications are those used to reduce or eliminate … Continue reading Revisiting migraines part 3: analgesia
Revisiting Migraine part 2: abortive medications
Since I am revisiting the topic of caring for kids with migraine, I thought I would jump right into medications next, treatment and then preventive. I am a firm believer in headache healthy lifestyle factors and their important for preventing migraines. I have discussed these quite a bit in the blog. So let’s talk about … Continue reading Revisiting Migraine part 2: abortive medications
Revisiting pediatric migraine, part 1
I realized today that it has been almost 4 years ago since I started writing regularly on this blog. Many things have changed, including medications, treatments and my knowledge about headaches. In the interim, I even managed to write a practical manual about caring for kids and teens with headaches. Much of the new information … Continue reading Revisiting pediatric migraine, part 1
Autonomic Nervous System Sensitivity
Mild dysfunction in the autonomic nervous system (ANS), also called mild dysautonomia is commonly comorbid with all primary headaches (migraine, TTH, NDPH). The ANS controls those body functions that we consciously have no control over, such as breathing, blood pressure regulation, heart rate regulation, digestion/GI motility, temperature regulation, sweating, or nervous system over-stimulation. Common causes … Continue reading Autonomic Nervous System Sensitivity
Headaches and psychiatric co-morbidities, part 2
In part 1 of this post, pain and psychiatric issues often travel together. Chronic headache pain can lead to long-lasting psychological distress, and depression and anxiety increase the perception of both acute and chronic pain. They are intimately connected. This post will continue the discussion about psychiatric co-morbidities and headache, focusing on psychopharmacology. What is … Continue reading Headaches and psychiatric co-morbidities, part 2
HeadFirst PNP 