Brian Grosberg

Mentioned in 1 episode

"The protocol went through a number of iterations until the current protocol, which is called the PREEMPT protocol, which is standard across the world, where injections are given in the forehead, on the sides of the head, the back of the head, the neck, and the shoulders around areas where there are superficial nerves."

Mentioned in 1 episode

"Beta blockers are a class of blood pressure medications. The exact mechanism of how they work isn't known. It's postulated that it may have effects on the sympathetic aspect of the nervous system. Two of the beta blockers that are FDA approved are propranolol and timolol, but there are other beta blockers that are used as well. They can be very effective for people."

Mentioned in 1 episode

"Some classes of pain medications, if they're used two or more days per week on a regular basis over an extended period of time, can actually create more frequent headaches. That could be NSAIDs and acetaminophen, or simple analgesics. It could even be triptans."

Mentioned in 1 episode

"A serendipitous finding that Botox was helpful for migraine. Botox has mostly been studied and where it has the current FDA approval for chronic migraine — people experiencing 15 or more days of headache per month. It's not by cosmetic effects that it works, but it interferes with the release of certain SNARE and SNAP proteins and also involvement in CGRP. It's administered quarterly."

Mentioned in 1 episode

"We actually ended up doing one of the largest studies looking at use in our patient population of people using cannabinoids. About a third of our patient population are using cannabinoids. The hard part becomes it's not standardized. It's very hard to tease apart whether it's direct benefit for headache or indirect benefit by helping with sleep or anxiety that may be comorbid with migraine."

Mentioned in 1 episode

"Two of the beta blockers that are FDA approved are propranolol and timolol, but there are other beta blockers that are used as well."

Mentioned in 1 episode

"Valproic acid, or Depakote, can have effects on GABA as well. That medication may be helpful but also has potential side effects. It's really important to consider the patient population — the vast majority of people with migraine are women — so reproductive age and contraception become important considerations."

Mentioned in 1 episode

"Stress reduction, whether it's meditation, biofeedback, or cognitive behavioral techniques — autonomic control — people sometimes focus on medications and don't realize it's a holistic approach, looking at the whole individual."

Mentioned in 1 episode

"A device like remote electrical neuromodulation, which is an armband device called Nerivio, worn on the arm, operated by an app on the phone, delivers a level of stimulation to a nerve in the arm that relays messages to the brain that uses the brain's own natural mechanisms to downregulate pain. Our headache center was actually the lead site in the world that led to that FDA clearance for that armband device."

Mentioned in 1 episode

"The two largest culprits for the possibility of medication overuse are opiates and barbiturate-containing combination analgesics like Fioricet or Fiorinal, which is even banned in some countries in the world."