Author: Jack Florin

Disappointing Results Of A Study Using Non-Invasive Vagal Nerve Stimulation In Chronic Migraine

Botox is the only approved prophylactic chronic migraine medication, although anticonvulsants, tricyclic antidepressants, and beta-blockers are often used off-label in chronic migraine, whereas several are on-label for episodic migraine. More effective treatment for chronic migraine is a great unmet need. Vagal nerve stimulation is approved for epilepsy and depression. Anecdotal reports of epilepsy patients treated… Read more »

Update On Supplements For Migraine

Many patients with migraine use “complementary and alternative medicine” and often do not discuss this with their physicians. There have been guidelines from various professional societies, and recommendations often conflict. The greatest number of studies has been done with riboflavin, coenzyme Q10, magnesium, butterbur, feverfew, and omega-3 polyunsaturated fatty acids. Nutraceuticals are lightly regulated by… Read more »

More Good News About Migraine Prevention

There are now 4 monoclonal antibodies that block calcitonin gene-related peptide (CGRP) or its receptor in clinical trials. A post-hoc analysis of a phase II trial, which was reported in Lancet Neurology, November 2015, and showed positive results, now found that the highest dose of the medication shows an effect within the first 3 days… Read more »

Is New Daily Headache Caused By Giant Cell Arteritis?

New daily persistent headache is a diagnosis seen frequently at headache centers. These are patients with no previous history of headache who recall a particular day when they developed a headache which has never improved. They are usually seen several months later after they have had normal neuroimaging and been treated with analgesics. In a… Read more »

“Preferred” By Whom?

Certainly, not by multiple sclerosis patients or their physicians. The more MS treatments that are available, the more complicated and confusing is the tiered system of drug prices. A pharmacy benefit provider contracted by an insurer is allowed to decide what is “preferred,” “nonpreferred,” or “not covered.” These decisions are made solely on the basis… Read more »

A New Treatment For Parkinson’s?

A new study has shown that men but not women who have higher urate concentrations had a lower future risk of developing Parkinson’s. It suggested that urate could be protective against risk for Parkinson’s and possibly could slow disease progression during the preclinical stage. Urate is an antioxidant. Several studies have shown that patients with… Read more »

Prediction Of Disability Progression In Multiple Sclerosis Continues To Be Refined

Several studies presented at the 2015 ECTRIMS Conference addressed the issue of how to assess treatment response after the first year, specifically whether the appearance of new MRI lesions or new relapses is reliable. At least 7 studies have shown that newly diagnosed patients, started on interferon and assessed at 1 year, have very high… Read more »

Stem Cell Tourism: Caveat Emptor

Stem cell pseudomedicine is on the rise, becoming highly profitable as patients and families are desperate for a cure for devastating and incurable neurological diseases, such as amyotrophic lateral sclerosis and multiple sclerosis. Treatment with “cellular therapy” usually costs between $15,000 and $20,000, is not covered by insurance, and is more widely available overseas than… Read more »

Migraine, Fibromyalgia, and Suicide Risk

Fifteen percent of the population has migraine and 2% to 8% fibromyalgia, with both disorders more common in women than men and with fibromyalgia being more common with increasing age, especially around 50 years old. In a recent study published in Neurology, September 2015, ten percent of migraine patients in a headache clinic had fibromyalgia…. Read more »

New Genetic Study About low Vitamin D and Multiple Sclerosis Risk

The evidence for low vitamin D levels being a risk factor for development of MS is becoming more compelling. In fact, some studies have shown that low vitamin D early in the disease course predicted worse MS clinical and MRI activity and disease progression. A new study sheds light as to why this might be…. Read more »