# LLMs.txt - Sitemap for AI content discovery # New York Headache Center > --- ## Pages - [My account](https://nyheadache.com/my-account/): - [Shop](https://nyheadache.com/shop/): - [Cart](https://nyheadache.com/cart/): - [Checkout](https://nyheadache.com/checkout/): - [Sara Crystal](https://nyheadache.com/staff/sara-crystal/): Sara Crystal, MD   Board Certified Neurologist and Headache Specialist Dr. Crystal completed her medical school at Rush University in... - [Britany Klenofsky, MD](https://nyheadache.com/staff/britany-klenofsky-md/): Britany Klenofsky, MD Associate Director   Dr. Britany Klenofsky is an Associate Director of the New York Headache Center. She... - [Alexander Mauskop](https://nyheadache.com/staff/alexander-mauskop/): Alexander Mauskop, MD Director Dr. Mauskop is the Director and founder of the New York Headache Center. He is board-certified... - [Our Staff](https://nyheadache.com/staff/): Director Associate Director Marcella Caprara, FNP-BC Richelle Cassell, FNP-C ​   - [Diagnosis](https://nyheadache.com/scientific-articles/diagnosis/): (Review article for physicians and patients seeking further information) INTRODUCTION It is estimated that up to 40 million people in... - [Pain](https://nyheadache.com/scientific-articles/pain/): Pain Review article for physicians Method of Alexander Mauskop, MD New York Headache Center, New York, NY.   From Conn’s... - [Trigeminal Neuralgia](https://nyheadache.com/scientific-articles/trigeminal-neuralgia/): Trigeminal Neuralgia (tic douloureux)   (Review article for physicians; please also see this blog post about the use of Botox... - [Headaches in Sports](https://nyheadache.com/scientific-articles/headaches-in-sports/): Headaches in Spots By Alexander Mauskop, MD and Boris Leybel, MD Introduction Chronic headaches afflict over 40 million Americans. Athletes... - [Headaches in Children](https://nyheadache.com/scientific-articles/320-2/): By: Alexander Mauskop, M. D. , Director , New York Headache Center The problem of headaches in children is often... - [Types of Headaches](https://nyheadache.com/scientific-articles/types-of-headaches/): Types of Headaches TENSION-TYPE HEADACHES This type of headaches is described as pressing or tightening in quality, of mild or... - [Botox](https://nyheadache.com/scientific-articles/botox/): Botox Dr. Mauskop was one of the first headache specialists to begin injecting Botox (onabotulinumtoxinA) for headache disorders in 1992.... - [About Therapies (pdf)](https://nyheadache.com/educational-materials/about-therapies/): About Therapies   In mid-March we started enrollment in a trial of a very safe electrical brain stimulation method, transcranial direct... - [Nutrition](https://nyheadache.com/educational-materials/educational-materialsnutrition/): Nutrition NUTRITIONAL ISSUES IN MIGRAINEAn awareness of nutritional issues that may affect migraines can be very helpful in decreasing the... - [Vitamins B12](https://nyheadache.com/educational-materials/vitamins-b12/): Vitamins B12 Vitamin B12, also called cobalamine because it contains the rare metal cobalt, is extremely important for the functioning... - [Nerve Block and Injections](https://nyheadache.com/educational-materials/nerve-block-and-injections/): Nerve Block and Injections Many headache patients have muscle spasms around the neck and shoulders. Injections of lidocaine often provide... - [Alternative therapies for children](https://nyheadache.com/educational-materials/alternative-therapies-for-children/): Alternative therapies for children   NATIONAL HEADACHE FOUNDATIONNHF Headlines, Winter, 2011 (The contents have been modified and updated from the... - [Caffeine and Headaches](https://nyheadache.com/educational-materials/caffeine-and-headaches/): Caffeine and Headaches Caffeine is included in many over-the-counter and prescription medications. It helps relieve migraines by constricting blood vessels... - [Medications](https://nyheadache.com/educational-materials/medications/): Medications In addition to the information you see on this page, please check my series of blog posts, 100 Migraine... - [Magnesium and Headaches](https://nyheadache.com/educational-materials/magnesium-and-headaches/): Magnesium and Headaches Magnesium administered orally or by slow infusion in the office is a safe and effective treatment for... - [Dental Appliances](https://nyheadache.com/educational-materials/dental-appliances/): Dental Appliances Many patients with headaches and facial pain are being diagnosed with TMJ syndrome or temporo-mandibular joint disorder. While... - [Cognitive-Behavioral Therapy, Meditation, and Biofeedback](https://nyheadache.com/educational-materials/cognitive-behavioral-therapy-and-biofeedback/): Cognitive-Behavioral Therapy, Meditation, and Biofeedback Many people feel that they do not have time to engage in cognitive techniques. They... - [Botox](https://nyheadache.com/educational-materials/botox/): Botox Dr. Mauskop was one of the first headache specialists to begin injecting Botox for chronic migraines and other pain... - [Acupuncture](https://nyheadache.com/educational-materials/acupuncture/): Acupuncture Acupuncture has truly withstood the test of time since it was first practiced in China for over two thousand... - [Hemicrania Continua](https://nyheadache.com/educational-materials/hemicrania-continua/): Hemicrania Continua Hemicrania continua (HC) is a rare type of headache disorder characterized by a continuous, moderate, one-sided headache. This... - [Medication Overuse Headache](https://nyheadache.com/educational-materials/medication-overuse-headache/): Medication Overuse Headache Medication overuse headache (MOH) is a chronic daily headache caused by the use of too much acute... - [Cluster Headache](https://nyheadache.com/educational-materials/cluster-headache/): Cluster Headache Cluster headache is perhaps the most painful and severe type of headache.  The term “cluster” is used because... - [Menstrual Migraine](https://nyheadache.com/educational-materials/menstrual-migraine/): Menstrual Migraine Migraine is a common and debilitating disorder that affects millions of Americans. Though migraine occurs with the same... - [Daily Headache](https://nyheadache.com/educational-materials/daily-headache/): Daily Headache Chronic daily headache (CDH) is a very common type of headache.  It occurs in 4-5% of the population,... - [Migraine Headaches](https://nyheadache.com/educational-materials/migraine-headaches/): Migraine Headaches Migraine is a very common headache disorder.  It affects approximately 18% of women and 6% of men in... - [NYHC in the Press, TV, Internet](https://nyheadache.com/in-the-press/): NYHC in the Press & TV Dr. Mauskop introducing Nobel Prize laureate Elie Wiesel at The First International Headache Summit... - [Scientific Articles](https://nyheadache.com/scientific-articles/): Scientific Articles Articles on the right side of the menu are readable from the browser. Dr. Allan Purdy’s review of... - [NYHC Educational Symposia & Doctor Training](https://nyheadache.com/educational-symposia/): NYHC Educational Symposia & Doctor Training In addition to many medical students and neurology residents, well over 200 doctors from... - [Lecture Slides](https://nyheadache.com/lecture-slides/): Neurology Grand Rounds presented at SUNY Downstate Medical Center on May 18, 2018 Download powerpoint slides (. ppt): SUNY Grand Rounds CGRP... - [Testimonials & Feedback](https://nyheadache.com/testimonials-feedback/): Elie Wiesel was a Holocaust survivor, Nobel Peace Prize winner, writer, university professor, and a tireless campaigner for human rights. He... - [Educational Materials](https://nyheadache.com/educational-materials/): In addition to the older but still relevant articles listed on the right, Dr. Mauskop’s blog contains up-to-date information on... - [How Our Office Works](https://nyheadache.com/how-our-office-works/): Our locations: 30 East 76th Street (corner of Madison Avenue), 2nd floor, New York, NY 10021 (our building is old... - [Address & Contact](https://nyheadache.com/address-contact/): Address & Contact Manhattan: 30 East 76th Street, New York, NY 10021 Tel: 212-794-3550 (appointments, general questions, prior authorizations, &... - [Home](https://nyheadache.com/):   Welcome to the New York Headache Center Dr. Mauskop’s latest book, The End of Migraines: 150 Ways to Stop... - [Welcome to the New York Headache Center](https://nyheadache.com/home-2/): Welcome to the New York Headache Center Dr. Mauskop’s latest book, The End of Migraines: 150 Ways to Stop Your... ## ## Posts - [Test title-3](https://nyheadache.com/test-title-3/): Test content-3 - [Test title-2](https://nyheadache.com/test-title-2-2/): Test content-2 - [Test title-1](https://nyheadache.com/test-title-2/): Test content-1 --- # # Detailed Content ## Pages ### My account - Published: 2021-06-19 - Modified: 2021-06-19 - URL: https://nyheadache.com/my-account/ --- ### Shop - Published: 2021-06-19 - Modified: 2021-06-19 - URL: https://nyheadache.com/shop/ --- ### Cart - Published: 2021-06-19 - Modified: 2021-06-19 - URL: https://nyheadache.com/cart/ --- ### Checkout - Published: 2021-06-19 - Modified: 2021-06-19 - URL: https://nyheadache.com/checkout/ --- ### Sara Crystal - Published: 2019-12-18 - Modified: 2024-08-29 - URL: https://nyheadache.com/staff/sara-crystal/ Sara Crystal, MD  Board Certified Neurologist and Headache Specialist Dr. Crystal completed her medical school at Rush University in Chicago and her neurology residency at NYU Medical Center. She then completed a headache fellowship at the Montefiore Headache Center, Albert Einstein College of Medicine, Bronx, NY. She has conducted research and published scientific articles in the field of headaches. Dr. Crystal is currently an Assistant Professor of Clinical Neurology at the NYU School of Medicine. Dr. Crystal was selected by her peers as a “rising star” in the 2018 and 2019 editions of the New York Times Magazine supplement, SuperDoctors. Dr. Crystal is a Clinical Assistant Professor of Neurology at SUNY Downstate Health Sciences University Download Curriculum Vitae (pdf)CV Crystal, Sara 12-19 OUR STAFF Alexander Mauskop, MD Britany Klenofsky, MD Sara Crystal, MD Cecelia Truong, FNP-C Richelle Cassell, FNP-C --- ### Britany Klenofsky, MD - Published: 2019-12-18 - Modified: 2024-12-24 - URL: https://nyheadache.com/staff/britany-klenofsky-md/ Britany Klenofsky, MD Associate Director  Dr. Britany Klenofsky is an Associate Director of the New York Headache Center. She is a neurologist with Board certification in Neurology as well as Headache Medicine. She is a Clinical Assistant Professor of Neurology at SUNY Downstate Health Sciences University Dr. Klenofsky received her MD degree from the Renaissance School of Medicine at Stony Brook University. Following medical school, she completed her residency in Neurology and fellowship training in Headache Medicine at the Mount Sinai Hospital in New York City. After completing her fellowship she worked as an attending neurologist at the Mount Sinai’s Headache Center. During her time there, she also served as an Assistant Professor of Neurology. Dr. Klenofsky was awarded Residency Teaching awards, completed numerous research projects, and has had her writings published in a variety of journals and book chapters. She has also been interviewed in a variety of media publications such as Self Magazine. She lives in New York city with her husband and son. Dr Klenofsky is licensed to practice medicine in New York, New Jersey and Florida. She can practice telemedicine in those states.  OUR STAFF Alexander Mauskop, MD Britany Klenofsky, MD Sara Crystal, MD Cecelia Truong, FNP-C Richelle Cassell, FNP-C --- ### Alexander Mauskop - Published: 2019-12-18 - Modified: 2024-05-30 - URL: https://nyheadache.com/staff/alexander-mauskop/ Alexander Mauskop, MD Director Dr. Mauskop is the Director and founder of the New York Headache Center. He is board-certified in Neurology with subspecialty certification in Headache Medicine. Dr. Mauskop is a Fellow of the American Academy of Neurology, American Headache Society, and New York Academy of Medicine. He is a Professor of Clinical Neurology at SUNY Downstate Medical Center. 2023 is the 25th year Dr. Mauskop has been selected by his peers as a Castle Connolly Top Doctor. Dr. Mauskop has been conducting research in the field of headaches for over 30 years and has published numerous articles in scientific journals. He has delivered over 500 scientific presentations and lectures and serves as a reviewer for the New England Journal of Medicine, Neurology, Headache, and other medical journals. He has given lectures at institutions such as Cornell, Harvard, Columbia, NYU and Dartmouth Medical Schools, Mayo and Cleveland Clinics. Well over 200 doctors from around the world have visited the New York Headache Center to learn advanced treatment techniques, such as Botox injections, nerve blocks, magnesium infusions, and other. Two editions of his book for doctors, Migraine and Headache have been published by Oxford University Press. Dr. Mauskop is a licensed acupuncturist, an expert in functional medicine, and the author of The Headache Alternative: A Neurologist’s Guide to Drug-Free Relief, a book published by Dell and What Your Doctor May Not Tell You About Migraines: The Breakthrough Program That Can Help End Your Pain, a book published by Warner Books. Dr. Mauskop’s most recent book, The... --- ### Our Staff - Published: 2019-12-18 - Modified: 2024-12-24 - URL: https://nyheadache.com/staff/ Director Associate Director Marcella Caprara, FNP-BC Richelle Cassell, FNP-C​  OUR STAFF Alexander Mauskop, MD Britany Klenofsky, MD Sara Crystal, MD Cecelia Truong, FNP-C Richelle Cassell, FNP-C --- ### Diagnosis - Published: 2012-12-07 - Modified: 2016-07-06 - URL: https://nyheadache.com/scientific-articles/diagnosis/ (Review article for physicians and patients seeking further information) INTRODUCTION It is estimated that up to 40 million people in the United States suffer from chronic headaches. These headache sufferers often do not receive treatment because they believe that doctors will consider the problem to be trivial, or they are unaware that treatment is available. Patients who do consult a physician are usually those whose headaches significantly disrupt their lives. Public education about available treatments - through the media and practicing physicians - is a work in progress HISTORY Most of the information leading to the diagnosis of the headache type is obtained from the patient's history. 1. Frequency and duration. Increasing frequency or duration of headaches indicates the need for a re-evaluation of a previously-diagnosed patient. Daily headaches are often the result of caffeine or medication overuse. Very brief, but intense and frequent (several times a day) headaches in women suggest the diagnosis of chronic paroxysmal hemicrania which almost always responds to indomethacin. 2. Time patterns. Tension-type headaches tend to worsen as the day progresses but it is not unusual to have a tension headache upon awakening. Cluster headaches tend to be very regular in their time of occurrence. They typically awaken patients from sleep in the early morning hours. A patient who wakes up with a headache that quickly resolves without medications should receive immediate further evaluation to rule out a brain tumor or other space occupying lesion. 3. Character and location of pain. Unilateral and pulsatile pain... --- ### Pain - Published: 2012-12-07 - Modified: 2019-12-21 - URL: https://nyheadache.com/scientific-articles/pain/ Pain Review article for physicians Method of Alexander Mauskop, MD New York Headache Center, New York, NY.   From Conn's Current Therapy, 1996 PHARMACOTHERAPY Major advances are being made in the development of new drugs for pain and several are approved by the FDA each year. Pharmacological management remains the mainstay of treatment for many pain syndromes. The three primary groups of drugs used in pain management are non-steroidal anti-inflammatory drugs or NSAIDs, opioids and adjuvant medications.   NSAIDs Many patients, before seeking medical care, try over-the-counter NSAIDs such as aspirin, ibuprofen (Advil, Motrin), or ketoprofen (Orudis).   The physician must establish that the dosage and the frequency of self-administration was sufficient before giving up on this group of medications. Failure of one NSAID to relieve pain does not mean that another one will not be effective. Side effects can also be idiosyncratic. For example, naproxen (Naprosyn) and indomethacin (Indocin) can produce GI side effects in a particular patient while naproxen sodium (Anaprox) and diclofenac (Voltaren) do not.   NSAIDs can be surprisingly effective in the relief of pain from metastatic bone disease. Opioids and NSAIDs have a different mechanism of action and together can have a synergistic effect. This combination may reduce the dose requirement of an opioid with a concomitant reduction in side effects. Longer acting NSAIDs, such as naproxen (Naprelan), piroxicam (Feldene), given at 20 mg once a day or diflunisal (Dolobid), given at 500 mg twice a day, choline magnesium trisalicylate (Trilisate) given at 1500 mg... --- ### Trigeminal Neuralgia - Published: 2012-12-07 - Modified: 2019-12-21 - URL: https://nyheadache.com/scientific-articles/trigeminal-neuralgia/ Trigeminal Neuralgia (tic douloureux)   (Review article for physicians; please also see this blog post about the use of Botox for trigeminal neuralgia)   Alexander Mauskop, M. D. Director, New York Headache Center   From Journal of Pain and Symptoms Management, 1993.   Abstract Trigeminal neuralgia is not a common but a debilitating pain syndrome.  After the diagnosis is established, a stepwise approach to treatment is recommended.  Carbamazepine is the drug of choice.  When carbamazepine fails to relieve pain baclofen and then phenytoin are used.  A number of second-line drugs, such as clonazepam, divalproex sodium, chlorphenesine carbamate and pimozide can also be tried.  A large number of patients will respond to one or another drug or to a combination of 2 drugs.  When medical treatment fails several surgical procedures have been found to be effective.  Percutaneous radiofrequency gangliolysis is the most widely used procedure with a high success rate.  An experienced physician must perform all surgical procedures in order to achieve the lowest possible rate of serious complications.   Key Words:  trigeminal neuralgia, carbamazepine, baclofen, phenytoin, clonazepam, divalproex sodium, pimozide, radiofrequency gangliolysis, microvascular decompression.     Trigeminal neuralgia (TN) or tic douloureux is associated with one of the most severe types of pain.  The incidence of this condition according to the published studies seems to be too low, judging from personal experience.  This may be in part because each patient leaves a strong and lasting impression.  Their suffering is unusually intense and frightening.  Fortunately, majority of these patients can be... --- ### Headaches in Sports - Published: 2012-12-07 - Modified: 2019-12-21 - URL: https://nyheadache.com/scientific-articles/headaches-in-sports/ Headaches in Spots By Alexander Mauskop, MD and Boris Leybel, MD Introduction Chronic headaches afflict over 40 million Americans. Athletes are a special category of patients who can experience headaches that are specific to their sports. A survey of 178 medical students and 190 physical education students (Williams 1) showed that 35% of both groups suffered from sport- and exercise-related headaches. Among men, more physical education students suffered from headaches, probably due to high frequency of trauma-related headaches in contact sports. The widely accepted International Headache Society's (IHS) classification (1) often does not distinguish between various subtypes of sports-related headaches. This usually indicates lack of sufficient data   about a particular headache type that prevents proper classification. Because IHS diagnostic categories are widely used we will use both the commonly-used term as well as IHS classification (Table 1). The clue to correct diagnosis and effective treatment of an athlete with headaches lies in a detailed history. It is necessary to establish circumstances surrounding the onset of pain, possible precipitating factors, character of the pain (i. e. throbbing, pressure-like, sharp, stabbing, exploding, etc. ), location of the pain, preceding and accompanying symptoms, such as nausea, vomiting, diarrhea, vertigo, nasal congestion, lacrimation, weakness, sensory symptoms, dysarthria, confusion, scintilating scotomata and other visual disturbances. Other factors that must be considered include history of non-sports related headaches, family history of headaches, prior and current illnesses, excessive caffeine intake, psycho-social factors and substance abuse. In addition to a thorough neurological evaluation a majority of athletes... --- ### Headaches in Children - Published: 2012-12-07 - Modified: 2019-12-21 - URL: https://nyheadache.com/scientific-articles/320-2/ By: Alexander Mauskop, M. D. , Director , New York Headache Center The problem of headaches in children is often not taken seriously by both parents and pediatricians alike. While they may not be as prevalent as in adults (migraines occur in 6% in children as opposed to 12% in adults), headaches in children are quite frequent and deserve more attention than they have received. Many adult migraine sufferers report having attacks for as long as they can remember , and children as young as 2 have been known to suffer from headaches. The distribution of headaches between girls and boys is even until puberty when girls begin to outnumber boys. Among the reasons for a parent's inattention to a child's headache is reluctance to accept the child's complaint as real or severe enough to warrant a visit to the doctor. Even if parents themselves suffer from headaches they are still doubtful, thinking that the child may be mimicking the parent's complaint to get attention, or to avoid school or a household chores. Occasionally parents think that diagnosis of migraine will stigmatize their child and will interfere with a future career. Unfortunately, very often no medical attention is sought for a child with headaches. The active treatment of headaches in childhood is very important since it has been reported that chronic severe migraine headaches can sometimes cause permanent disabilities. Diagnosis Once the child is brought to a physician, he or she will usually make sure that no other serious condition is... --- ### Types of Headaches - Published: 2012-12-07 - Modified: 2019-12-21 - URL: https://nyheadache.com/scientific-articles/types-of-headaches/ Types of Headaches TENSION-TYPE HEADACHES This type of headaches is described as pressing or tightening in quality, of mild or moderate intensity, bilateral in location, without associated nausea, photophobia or phonophobia. It is not made worse by routine physical activity as may be the case with migraine headaches. Tension headaches are the most common type of headache and have many precipitating factors. Removal of identifiable causes and precipitating factors is the ideal way to treat this type of headache. Although the most common precipitating factor - stress - is often difficult to alleviate, reducing the physical effects of stress can be achieved through both non-pharmacological and pharmacological methods MIGRAINE HEADACHES Article to come. SINUS HEADACHES Article to come. MEDICATION OVERUSE OR REBOUND HEADACHES These headaches usually occur in patients with migraines who take abortive medications too frequently, which leads to worsening of migraines. Abortive medications are the ones that are taken as needed to stop an individual migraine attack. The second type of migraine medications is prophylactic medications, which are taken daily to prevent migraine attacks. Not all abortive medications are equally likely to result in medication overuse (MOH) or rebound headaches. The strongest evidence we have is for caffeine-containing medications such as over-the-counter products, Excedrin, Excedrin-Migraine, Anacin and prescription drugs, Fiorinal (butalbital, aspirin, caffeine), Fioricet (butalbital, acetaminophen, caffeine), Esgic, and other. MOH can be also caused by dietary caffeine. As little as 2 cups of coffee per day can cause rebound headaches in a susceptible individual. Studies suggesting that... --- ### Botox - Published: 2012-12-07 - Modified: 2019-12-21 - URL: https://nyheadache.com/scientific-articles/botox/ Botox Dr. Mauskop was one of the first headache specialists to begin injecting Botox (onabotulinumtoxinA) for headache disorders in 1992. Over the past 25 years he has performed this procedure on thousands of patients, ranging from 8 to 98 years of age, with positive results in about 70% of headache sufferers. He has participated in several large clinical trials of Botox, published scientific articles, given lectures, and participated in courses that trained hundreds of physicians in how to inject Botox. Well over 200 doctors from across the US, Canada, and Europe has visited Dr. Mauskop to learn how to administer Botox for migraines and other types of headaches and pain. These two short videos (video 1 and video 2) demonstrate the procedure of Botox injections for chronic migraines. The second one includes injections into the masseter muscles for TMJ syndrome. The entire procedure takes 3 to 4 minutes and causes little discomfort. Botox (onabotulinumtoxinA) was first approved by the FDA in 1989 for the treatment of eye disorders, blepharospasm and strabismus. It was noticed that wrinkles around the eyes would disappear after Botox injections, and Botox became widely used for treating facial lines. In turn, many people who had wrinkles treated noticed improvement in their headaches. Scientific studies and our experience confirm that Botox injections can indeed relieve chronic migraine headaches. In 2010 the FDA approved Botox for the treatment of chronic migraine headaches. The effect of a single Botox treatment lasts on average 3 months. The procedure takes 10 minutes... --- ### About Therapies (pdf) - Published: 2012-12-06 - Modified: 2019-12-21 - URL: https://nyheadache.com/educational-materials/about-therapies/ About Therapies   In mid-March we started enrollment in a trial of a very safe electrical brain stimulation method, transcranial direct current stimulation (tDCS), for the prevention of migraines. You need to have at least 4 migraine days a month and not be getting Botox or CGRP injections.   Please see this blog post or call 212-794-3550 to find out more. Download the following articles in PDF format: Acupuncture Biofeedback Botox Cognitive therapy Dental therapy Herbs, Vitamins & Minerals (MigreLief) Magnesium Medications Nerve Blocks & Injections Neurological Consultation  -  missing Nutrition Vitamin B12 Download Adobe Acrobat Reader   --- ### Nutrition - Published: 2012-12-06 - Modified: 2019-12-21 - URL: https://nyheadache.com/educational-materials/educational-materialsnutrition/ Nutrition NUTRITIONAL ISSUES IN MIGRAINEAn awareness of nutritional issues that may affect migraines can be very helpful in decreasing the occurrence of headaches.  People who suffer from migraines should know which foods can potentially trigger headaches, and what types of eating patterns are best for avoiding headaches. Some people know exactly what foods consistently trigger their headaches, but others may not be able to accurately pinpoint their food triggers.  Often a food diary is helpful in determining which foods are linked to your migraines. Eating To Prevent HeadachesThe importance of eating regularly cannot be overstated, since skipping meals can trigger headaches.  Skipped meals and fasting were reported migraine triggers in more than half of patients surveyed in several studies.  Low blood sugar can trigger headaches so it is important to eat breakfast, lunch and dinner everyday. Many people skip breakfast, which puts them at risk for having headaches in the morning.   Snacks in the mid-morning and mid-afternoon might also be helpful for people who find that their headaches are often triggered by hunger. Also, spikes and falls in your blood sugar can trigger headaches. Eating protein and fiber with each meal can help to stabilize the way the food is broken down by your body, thus preventing large fluctuations in blood sugar.  For example, having cereal with milk (which has protein) is a better breakfast choice than a big muffin, which is generally high in sugar and low in protein.   Protein-rich foods include: meat, fish, poultry, eggs, dairy,... --- ### Vitamins B12 - Published: 2012-12-06 - Modified: 2019-12-21 - URL: https://nyheadache.com/educational-materials/vitamins-b12/ Vitamins B12 Vitamin B12, also called cobalamine because it contains the rare metal cobalt, is extremely important for the functioning of the nervous system and the production of red blood cells. The medical and scientific communities have recognized the importance of this vitamin for almost 50 years; in fact, two Nobel prizes have been awarded for research on vitamin B12. Severe deficiency of vitamin B12 can result in serious illness, or even death. As with other vitamins, however, only a small amount of vitamin B12 is required for normal functioning of the body. In a healthy person a well-balanced diet will provide sufficient amounts of vitamin B12.   Foods that are especially high in vitamin B12 include liver, fish, and dairy products. Most people consume an average of about 10-30 micrograms of vitamin B12 daily, only about 1-3 micrograms of which is required for normal functioning of our bodies. There are several conditions, however, that may predispose people to vitamin B12 deficiency. Strict vegetarians and their infants are at risk of vitamin B12 deficiency, as are smokers, people with gastro-intestinal problems or poor absorption of nutrients, or those infested with fish tapeworms. Several congenital diseases or chronic diseases and certain drugs have also been associated with vitamin B12 deficiency. For example, the peripheral nerve damage frequently seen in people with diabetes has been attributed to the effect of high sugar levels in the blood; however diabetics have also been found to have lower levels of B vitamins. Although supplementation of... --- ### Nerve Block and Injections - Published: 2012-12-06 - Modified: 2019-12-21 - URL: https://nyheadache.com/educational-materials/nerve-block-and-injections/ Nerve Block and Injections Many headache patients have muscle spasms around the neck and shoulders. Injections of lidocaine often provide temporary relief, which may be needed prior to starting a program of neck-strengthening exercises and other treatments. When the muscle spasm continues to return after lidocaine injections, injections of Botox into neck and shoulder muscles may provide more long-lasting relief. Headaches can result from "pinched" nerves around the head. This condition is particularly common in elderly headache sufferers and in the case of headaches caused by head or neck injury. The occipital nerve is one of the most commonly affected nerves. Blocking the involved nerve with lidocaine or steroids (cortisone) can be very effective in relieving this type of headache. Sphenopalatine ganglion (SPG) block is not exactly a nerve block because instead of blocking a single or several nerve trunks, SPG block involves blocking (numbing) a collection of nerve cells. SPG is located behind the nose and right underneath the skull and its cells send nerve endings into the brain as well as to the face and head. Numbing this ganglion appears to be very effective for some patients with migraines, cluster headaches, and facial pain. The SPG block can be done painlessly with a special device which delivers the numbing medicine (bupivacaine) through a thin plastic catheter inserted through the nose. Here is more information on the SPG block. --- ### Alternative therapies for children - Published: 2012-12-06 - Modified: 2019-12-21 - URL: https://nyheadache.com/educational-materials/alternative-therapies-for-children/ Alternative therapies for children   NATIONAL HEADACHE FOUNDATIONNHF Headlines, Winter, 2011 (The contents have been modified and updated from the original publication) Kids KORNER Complementary and Alternative Therapies By Alexander Mauskop, MD, FAAN,Director of the New York Headache Center, New York NY (You may also want to read this article on headaches in children elsewhere on our site) Parents of kids with headaches frequently ask about complementary and alternative approaches, hoping to avoid prescription medications and their associated side effects. As it turns out scientific studies have shown that many of these alternative treatments can be beneficial in reducing headaches, with very few side effects. Taking these factors into account, the treatments described below are worth trying by most, if not all, headache sufferers. However, before considering any kind of medication, whether conventional or alternative the first step is to make sure that the child has healthy habits. Parents and children, especially adolescents, should be counseled about the importance of regular and nutritious meals without any caffeine, chocolate or other known dietary migraine triggers. Frequent exercise and regular sleeping patterns are also important factors in decreasing headaches. Stress is a major contributor to headaches, even in young children. One of the best treatments for migraine and tension-type headaches is biofeedback. Many studies have shown that biofeedback works well, with long-lasting benefits. However similar and less expensive techniques such as self-taught progressive relaxation and meditation, work equally well. The advantage of biofeedback is that a biofeedback therapist can make the learning... --- ### Caffeine and Headaches - Published: 2012-12-06 - Modified: 2019-12-21 - URL: https://nyheadache.com/educational-materials/caffeine-and-headaches/ Caffeine and Headaches Caffeine is included in many over-the-counter and prescription medications. It helps relieve migraines by constricting blood vessels and by directly relieving pain. However, caffeine is also a major cause of headaches, especially in the difficult-to-treat chronic migraines. People consuming large amounts of caffeine develop headaches not from caffeine, but due to caffeine withdrawal. This fact was confirmed by a double-blind study published in the New England Journal of Medicine. Half of the group of people, who normally did not suffer from headaches and were consuming only about 2 and 1/2 cups of coffee a day were switched to decaf. More than half of the people switched to decaf developed a headache, while the control group did not. Those people who are prone to having headaches are also much more prone to having caffeine-withdrawal headaches. The fact that caffeine causes headaches often comes as a surprise since many sufferers feel that caffeine in coffee, soda or medications actually makes them feel better. What they often don't realize is that they are just adding fuel to the fire. Patients who start taking Excedrin or another drug find that with time they need to take more and more of the medication with less and less relief. The only way to stop headaches in these patients is by stopping caffeine. Often it is not easy to do because headaches will first get worse before they get better. A physician can prescribe medications to relieve pain during the period of caffeine withdrawal, but... --- ### Medications - Published: 2012-12-06 - Modified: 2019-12-21 - URL: https://nyheadache.com/educational-materials/medications/ Medications In addition to the information you see on this page, please check my series of blog posts, 100 Migraine Drugs, A to Z. While we are big advocates of non-drug treatments, many people do require the use of medications to control headaches. Headache medications are divided into two categories. Abortive drugs are those that are used as needed when the headache occurs. They can be sufficient when headaches are infrequent. Prophylactic drugs are used for people with frequent attacks, and they are taken daily to prevent headaches. Many patients express the concern that they will need to take a daily medication for the rest of their lives.  This is not usually the case.  Daily prophylactic drugs are used until the headaches are under control, at which point they are tapered off. Research indicates that once headaches become well controlled with medications or Botox injections these treatments can be successfully discontinued in 50% of patient. We also try to use the lowest effective dose possible for the shortest period possible. Drug Treatment for Tension-type headaches Abortive medications such as painkillers and anti-inflammatory drugs are effective in treating tension-type headaches.  Medications containing caffeine or opioids (narcotics) should be limited to 1 to 2 doses per week because using them more often can lead to an increase in frequency of attacks, or so called rebound headaches. Patients who need more than this amount generally need daily prophylactic medication. a. Non-steroidal anti-inflammatory drugs (NSAIDs) such as aspirin (Migralex, a drug developed by Dr.... --- ### Magnesium and Headaches - Published: 2012-12-06 - Modified: 2019-12-21 - URL: https://nyheadache.com/educational-materials/magnesium-and-headaches/ Magnesium and Headaches Magnesium administered orally or by slow infusion in the office is a safe and effective treatment for migraine headache. It helps to prevent migraine in the magnesium-deficient person, and is particularly useful for patients who experience menstrual headaches. Magnesium infusion administered in our office can also be used to abort a severe migraine in progress. (Infusion is covered by some insurers. ) (The following is a review article written by Dr. Mauskop for physicians and patients seeking further information on magnesium and headaches) Magnesium is the second most abundant intracellular cation. It is the fourth most plentiful metal in the body. One to five percent of magnesium is in the extracellular fluid, 34 to 45 percent are intracellular and over 50 percent is contained in the mineral phase of the skeleton. About 75 percent of the serum magnesium is ionized, while the rest is protein-bound. Magnesium is an essential intracellular element and is involved in a large number of cell functions. Despite the recognition of its essential functions in the body, cardiovascular effects of magnesium deficiency, magnesium's role in the development of fetal brain, and its relaxing effect on smooth muscle in patients with asthma have been only recently widely acknowledged. Many studies of the role of magnesium in the pathogenesis of migraines looked at the intracellular magnesium content and they have produced conflicting results. This may be because intracellular magnesium content seems to be stable despite wide fluctuations in serum magnesium. Other studies examined the total serum... --- ### Dental Appliances - Published: 2012-12-06 - Modified: 2022-07-15 - URL: https://nyheadache.com/educational-materials/dental-appliances/ Dental Appliances Many patients with headaches and facial pain are being diagnosed with TMJ syndrome or temporo-mandibular joint disorder. While people who clench or grind their teeth in sleep may have a disorder of the TM joint, it is often the result of stress and muscle tension.   TMJ syndrome often coexists with migraines and tension headaches due to this common trigger. We find that treating the underlying tension with biofeedback, regular aerobic exercise and at times medications relieves all symptoms. Botox injections into the jaw muscles are also highly effective. There are other causes of TMJ syndrome, such as arthritis, trauma, misaligned lower jaw, and Lyme disease. --- ### Cognitive-Behavioral Therapy, Meditation, and Biofeedback - Published: 2012-12-05 - Modified: 2019-12-21 - URL: https://nyheadache.com/educational-materials/cognitive-behavioral-therapy-and-biofeedback/ Cognitive-Behavioral Therapy, Meditation, and Biofeedback Many people feel that they do not have time to engage in cognitive techniques. They don’t seem to understand that the busier they are the more they would benefit from meditation and relaxation training. Zen Buddhists say that you should meditate 20 minutes a day, unless you are too busy, in which case you should meditate for an hour. Cognitive and behavioral techniques provide a change from external to internal locus of control where patients no longer feel helpless in the face of their illness and stress, but instead gain a measure of some control over their condition. The most widely used behavioral treatments for headache include relaxation therapy, biofeedback therapy, and cognitive-behavioral/stress-management therapies. These approaches can be used in combination with pharmacologic and other non-pharmacologic therapies. Relaxation and biofeedback training enable patients to recognize, and learn to control, headache-related physiologic responses. These are the goals of cognitive-behavioral therapy: - Attempt to foster an internal locus of control and modify distress-related thoughts - Rehearse adaptive cognitive and behavioral responses to the development of a migraine - Accurately interpret body signals - Develop “action plans” - Reduce anxiety and depression - Recognize triggers An excellent website for self-administered cognitive-behavioral therapy, which is free or costs $50-$60 per course, is ThisWayUp. org. au. They have modules for anxiety, health-related anxiety, depression, PTSD, chronic pain, insomnia, and other. While self-taught relaxation techniques may be equally effective, biofeedback offers the advantage of having a “personal coach” teaching, motivating and... --- ### Botox - Published: 2012-12-05 - Modified: 2019-12-21 - URL: https://nyheadache.com/educational-materials/botox/ Botox Dr. Mauskop was one of the first headache specialists to begin injecting Botox for chronic migraines and other pain and headache disorders. Over the past 25 years he has performed this procedure thousands of times in over 3,000 patients with positive results in about 70% of headache sufferers. He has participated in several large clinical trials of Botox, published scientific articles, given lectures, and trained hundreds of physicians in how to inject Botox. These two short videos (video 1 and video 2) demonstrate the procedure of Botox injections for chronic migraines. The second one includes injections into the masseter muscles for TMJ syndrome. The entire procedure takes 3 to 4 minutes and causes little discomfort. Botox (onabotulinumtoxinA) was first approved by the FDA in 1989 for the treatment of eye disorders, blepharospasm and strabismus. It was noticed that wrinkles around the eyes would disappear after Botox injections, and Botox became widely used for treating facial lines. In turn, many people who had wrinkles treated noticed improvement in their headaches. Scientific studies and our experience confirm that Botox injections can indeed relieve chronic migraine headaches. In 2010 the FDA approved Botox for the treatment of chronic migraine headaches. The effect of a single Botox treatment lasts on average 3 months. The procedure takes 10 minutes to perform and is accompanied by minimal discomfort because of the very small needle size. According to the FDA-approved protocol 31 sites are injected with 155 units of Botox at each session. In our practice... --- ### Acupuncture - Published: 2012-12-05 - Modified: 2019-12-21 - URL: https://nyheadache.com/educational-materials/acupuncture/ Acupuncture Acupuncture has truly withstood the test of time since it was first practiced in China for over two thousand years. Hundreds of modern scientific studies have shown that acupuncture works through the release of neurotransmitters in the brain, which can result in relief of pain and other conditions. The National Institutes of Health (NIH) recently convened a panel of experts who concluded that acupuncture has a scientific basis, and that it has demonstrated efficacy in some conditions. In others, additional studies are required. At our Center acupuncture is performed by the Director of the Center, Alexander Mauskop, M. D. , who is a licensed acupuncturist. Unlike what many people imagine, acupuncture is usually a very pleasant experience. Many people fall asleep during the procedure. It is nearly painless because of a special insertion technique using very thin disposable needles. Each session lasts 20-30 minutes and a usual course of treatment consists of 10 weekly sessions. ACUPUNCTURE By: Alexander Mauskop MD From: National Headache Foundation Newsletter The first description of the use of acupuncture for the treatment of headaches is credited to a Chinese surgeon Hua Tuo (A. D. 110-207) in the Han dynasty. The fact that acupuncture has been used for thousands of years did not bring it a quick recognition in the western world. Only in the past five-to-ten years has acupuncture been given a solid scientific basis. Many physicians and patients, however, still consider acupuncture to a faith healing method. This in part is explained by the... --- ### Hemicrania Continua - Published: 2012-12-05 - Modified: 2019-12-21 - URL: https://nyheadache.com/educational-materials/hemicrania-continua/ Hemicrania Continua Hemicrania continua (HC) is a rare type of headache disorder characterized by a continuous, moderate, one-sided headache. This headache type was given its name because "hemicrania” refers to “half the head,” and “continua” refers to the continuous nature of the headache. Although HC is considered a rare type of headache, it is probably more common than originally believed. Many cases remain undiagnosed. It seems to be more common in women than in men. Patients with HC often complain of more severe flare-ups in addition to the continuous headache. During these flare-ups, “autonomic" features (related to dysfunction of the autonomic nervous system) are usually present, which include: a droopy eyelid, redness or tearing of the eye, forehead sweating, and runny or stuffy nose, all on the side of the headache. Eye discomfort is another common feature. Often a feeling of “sand” in the eye is described. Many people with HC report occasional stabbing pains in addition to the continuous headache. These intermittent jabs and jolts usually last less than 1 minute. Since HC is a relatively rare type of headache, not much is known about its cause. There does not seem to be a genetic component, and no specific causal factors have been identified. However, there may be an association with head trauma. One of the important features of hemicrania continua is its dramatic response to a medication called indomethacin. Indomethacin is a non-steroidal anti-inflammatory drug that is taken three times daily. Often a significant improvement in the headache... --- ### Medication Overuse Headache - Published: 2012-12-05 - Modified: 2019-12-21 - URL: https://nyheadache.com/educational-materials/medication-overuse-headache/ Medication Overuse Headache Medication overuse headache (MOH) is a chronic daily headache caused by the use of too much acute medication. It generally occurs in people with migraine or tension-type headaches who take drugs too often. When the effect of one dose wears off, a withdrawal reaction occurs, triggering the next headache and another round of medication. This results in a vicious cycle of daily headaches and increasingly frequent medication intake. MOH was previously called rebound headache, drug-induced headache, and medication-misuse headache. The most common cause of medication overuse headache is overuse of dietary caffeine or caffeine-containing drugs. MOH is likely to occur if you are taking opioid (narcotic), barbiturate (butalbital) or caffeine-containing medications on 2 or more days each week. Many doctors and even headache specialists think that over-the-counter pain medications, such as Tylenol or Advil can also cause medication overuse headaches, but scientific research conducted by Dr. Richard Lipton and his colleagues proved that these medications are very unlikely to worsen headaches. In his study thousands of people were followed for one year and had the frequency of migraine headaches and medications they were taking recorded. As little as one dose of a narcotic medication a week appears to increase the risk of worsening of headaches. Medications in the opioid (narcotic) category are codeine, hydrocodone (Vicodin), oxycodone (Percocet, Oxycontin), and many other. Taking aspirin actually makes it less likely that headaches will worsen over time. In fact, daily use of naproxen (Aleve, Naprosyn, Anaprox) has been shown to... --- ### Cluster Headache - Published: 2012-12-05 - Modified: 2019-12-21 - URL: https://nyheadache.com/educational-materials/cluster-headache/ Cluster HeadacheCluster headache is perhaps the most painful and severe type of headache.  The term "cluster" is used because these headaches come in clusters, occurring for weeks to months at a time, then disappearing suddenly and completely for months or years. Many people also report that the clusters occur with striking regularity in a cyclical daily or seasonal pattern.  Cluster headaches are often mistaken for sinus or migraine headaches.  Cluster headache is present in less than one percent of the population.  It is more commonly seen in men.  These headaches can begin at any age, but usually occur between the ages of 20 and 40 years.  Cluster headaches are not life-threatening and do not cause any permanent damage to the brain. However they can be quite debilitating and interfere with work and enjoyment of life. In a small number of cluster headache sufferers headaches continue for more than a few months, sometimes for years. These are called chronic cluster headaches. Cluster headache attacks often occur at night, waking the person from sleep.  The pain is usually described as sharp, stabbing, or burning, like a "hot poker in the eye. "Characteristic features include the following:Severe, one-sided pain in or around the eye, temple, forehead or cheek areasIndividual attacks lasting 15 minutes to 3 hours. Begins suddenly and peaks quickly (within minutes)Can occur from every other day to 8 times a daySense of agitation or restlessness during the headacheOften triggered by alcoholAccompanied by at least one of these "autonomic features" on the... --- ### Menstrual Migraine - Published: 2012-12-05 - Modified: 2019-12-21 - URL: https://nyheadache.com/educational-materials/menstrual-migraine/ Menstrual Migraine Migraine is a common and debilitating disorder that affects millions of Americans. Though migraine occurs with the same frequency in boys and girls, after puberty the girls outnumber boys. By adulthood, women are three times as likely to suffer from migraine as men. This is probably due to hormonal fluctuations which occur during women’s menstrual cycle, which can trigger headaches. Up to 60% of women with migraines report headaches around the time of menstruation. Approximately 7-14% of women have migraines exclusively at this time of the month. Migraines subside in 2 out of 3 women during pregnancy and after menopause - two conditions with steady estrogen levels. Migraine can occur before, during, or after menstruation.  Menstrual migraine is defined as a headache attack that occurs two days before and up to three days after the onset of a woman's period. The most common day on which menstrual migraine occurs is the first day of bleeding. Menstrual migraine is thought to be triggered by changes in hormone levels that occur during the menstrual cycle. The most likely cause is the fall in estrogen levels that takes place just before the beginning of menses. However, the full mechanism is not yet fully understood. Treatment of menstrual migraines requires special considerations.  Women should be aware that many of the drugs used in treating migraine are potentially dangerous in pregnancy. Also, menstrual migraine is often more difficult to treat than non-menstrual migraine. Women sometimes have to try several different treatment options before... --- ### Daily Headache - Published: 2012-12-05 - Modified: 2019-12-21 - URL: https://nyheadache.com/educational-materials/daily-headache/ Daily Headache Chronic daily headache (CDH) is a very common type of headache.  It occurs in 4-5% of the population, and is the leading problem seen in headache practices.  In the United States, up to 80% of patients seen in headache clinics have chronic daily headache.  As the name implies, CDH refers to headaches that are present very frequently, usually on more than 15 days per month. The subtypes are Chronic Migraine, Chronic Tension-Type Headache, New Daily Persistent Headache, Chronic Cluster Headache, Hemicrania Continua, Chronic Paroxysmal Hemicrania and Medication-Overuse Headache. The most common cause of CDH is medication overuse.  The regular use of caffeine-containing drugs (Excedrin, Anacin, Fioricet, Fiorinal, Esgic and other), barbiturates (Fiorinal, Fioricet, Esgic) and narcotics (Vicodin, Percocet, Tylenol with codeine, Oxycontin). Triptans, such as sumatriptan (Imitrex), rizatriptan (Maxalt) and other do not cause rebound or medication overuse headaches. Taking aspirin actually can reduce the chances of developing chronic migraine.  Many patients with CDH report that though they initially had only occasional migraines, they began having persistent low-grade daily headaches as they increased their medication use.  As the headache frequency increased, the acute medications (with caffeine, butalbital, or narcotics) seemed to become less and less effective. This happens because the acute medications are short-acting, and as the effect of one dose wears off a withdrawal syndrome occurs, triggering another headache and the need to take more medication. This pattern becomes a vicious cycle of daily headaches and frequent, albeit ineffective, medication intake. Furthermore, the overuse of acute medication... --- ### Migraine Headaches - Published: 2012-12-05 - Modified: 2019-12-21 - URL: https://nyheadache.com/educational-materials/migraine-headaches/ Migraine HeadachesMigraine is a very common headache disorder.  It affects approximately 18% of women and 6% of men in the United States.  Though migraine is most prevalent between the ages of 25 and 55, it affects all age groups, including children. While it is commonly believed that migraine is a one-sided headache, many migraine sufferers have pain on both sides of their head.  The pain of migraine is usually throbbing or pulsating, and can last for hours to days.  Associated features include nausea, vomiting, and sensitivity to light and sound.   When attacks occur, people are unable to function, and will often lie down in a dark room until the pain recedes.  Some people have migraines several times a week, while others get them only several times throughout their lives.  About 15% of migraine sufferers have “aura” before the start of the headache. Auras usually last 20-30 minutes and typically precede the headache, although they can occasionally occur during the headache.  Most auras are visual in nature and include bright flashing lights that move across the visual field (known as scintillating scotomata), zig-zagged lines, wavy images, and even loss of vision.   Auras can be non-visual as well, and may involve weakness or numbness on one side of the body, speech or language abnormalities, and dizziness.  The neurological mechanisms that cause migraine are very complex.  We now know that abnormalities in the "trigeminovascular system" are the underlying cause of migraine headaches.  The trigeminal nerve is a large nerve that has... --- ### NYHC in the Press, TV, Internet - Published: 2012-12-04 - Modified: 2025-04-15 - URL: https://nyheadache.com/in-the-press/ NYHC in the Press & TV Dr. Mauskop introducing Nobel Prize laureate Elie Wiesel at The First International Headache Summit held in Tel-Aviv, Israel, November 14-17, 2008.  Professor Wiesel spoke about his personal experience with chronic migraines.  New York Headache Center in the media: 8 Proven Ways to Prevent a Hangover, Newsmax, December 2024 Which Types of Magnesium Supplements Are Best for Migraine Relief?  MigraineAgain. com, 2024 Telltale Signs Your Body Lacks Magnesium NewsMax Health, December 24, 2024 Could a Heart Medication Help Prevent Migraine Attacks? The Benefits of Propranolol, Migraineagain. com, August 23, 2024  Who Should and Should Not Use Triptans for Migraine Relief, Migraineagain. com, August 2, 2024 Health Radar How to Cope with Holiday Hangovers, by Lynn C. Allison. December 2023 Insider newsletter. Magnesium and B2 stopped my daily headaches. Now I'm pain-free and go weeks without a migraine.  September 19, 2023 Health Radar Ask the Doctor with Alexander Mauskop: Getting Relief From Migraine Headaches, Vol. 12, Issue 12 / December 2022 Self Do the Coronavirus Symptoms Include Headache? April 22, 2020 Bottom Line, Inc podcast: 7 New Treatments for Migraines Just Released—with Alexander Mauskop, MD March 2020 LIPPISCHE LANDES-ZEITUNG · Nr. 181, Mehr Hoffnung für Migräne-Patienten07_08_LIP1_7 (1),  7. August 2019 SiriusXM Doctor Radio, August 7, 2019 Biopharmadive, Teva gives up on cluster headache for Ajovy, ending phase 3 study.   April 23, 2019 Video news piece on migraines on Quartz, a news site founded by the Atlantic, April 16, 2019 SiriusXM Doctor Radio, January 30, 2019Healthgrades Migraine Video Center, January... --- ### Scientific Articles - Published: 2012-11-07 - Modified: 2021-08-08 - URL: https://nyheadache.com/scientific-articles/ Scientific Articles Articles on the right side of the menu are readable from the browser. Dr. Allan Purdy's review of Dr. Mauskop's book, The End of Migraines: 150 Ways to Stop Your Pain. Dr. Mauskop is quoted in the June 22, 2017 issue of Neurology Today: External Vagus Nerve Stimulation for Episodic Cluster Headaches is Coming to the US Market Soon The following articles by Dr. Mauskop are available for download in PDF format: Nonmed, alternative, complementary treatments for migraine (Word doc) Intravenous magnesium sulphate relieves migraine attacks in patients with low serum ionized magnesium levels (. pdf) Diagnosis and Treatment of Migraine Headache in Adult Patients (. pdf) written for the California Medical Association Vagus Nerve Stimulation for Headaches (. pdf) Nutrition and Migraine (. pdf) Headaches in Children (. pdf) Headaches in Sports (. pdf) Trigeminal Neuralgia (. pdf) Pain (. pdf) Botulinum Toxin for Chronic Migraines – a Double-Blind Study (dodick mauskop) (. pdf) Role of Magnesium in Migraines (Magnesium in migraine Expert Review) (. pdf) Chronic migraine and Magnesium (One disease or two) (. pdf) Ionized Magnesium and Migraine (. pdf) IV magnesium for Cluster Headaches (IVMg cluster headache) (. pdf) Butterbur for Migraine Prophylaxis (Butterbur-Lipton) (. pdf) Alternative Approaches to Tension-Type Headache (Alt Tx TTH) (. pdf) Opioid Guidelines (. pdf) Download Adobe Acrobat Reader (-opens in new window) --- ### NYHC Educational Symposia & Doctor Training - Published: 2012-11-07 - Modified: 2023-05-12 - URL: https://nyheadache.com/educational-symposia/ NYHC Educational Symposia & Doctor Training In addition to many medical students and neurology residents, well over 200 doctors from around the world have visited the New York Headache Center to receive personal advanced training from Dr. Mauskop. Over the past 25 years, Dr. Mauskop has given over 500 presentations, including lectures and grand rounds at institutions such as Cornell, Harvard, Columbia, NYU, and Dartmouth Medical Schools, and Mayo and Cleveland Clinics.   He has been an invited speaker at the meetings of the American Academy of Neurology, American Headache Society, International Headache Society, and other medical groups in the US and around the world. If you are a healthcare provider and are interested in spending a day or several days at the NYHC, please contact Dr. Mauskop at DrMauskop@NYHeadache. com. Upcoming events and lectures:   Past events and lectures: International Headache Summit Photo of Dr. Alexander Mauskop and Elie Wiesel. The First International Headache Summit was held in Tel-Aviv, Israel, November 14-17, 2008. Keynote address by Nobel Prize Laureate, Elie Wiesel.           September 12, 2019. Dr. Mauskop with Professor Uwe Reuter of Charité and Dr. Zoltan Medgyessy.   Charité – Universitätsmedizin Berlin is Europe’s largest university hospital. The middle photograph shows the renowned Psychiatric and Neurologic Clinic entrance at Charité. On the bottom, Dr. Mauskop in the lecture hall with portraits of physicians, who after 1933 were dismissed and persecuted for political or racial reasons. Estonian neurologist, Dr. Siim Schneider visited the New York Headache Center... --- ### Lecture Slides - Published: 2012-11-07 - Modified: 2018-09-03 - URL: https://nyheadache.com/lecture-slides/ Neurology Grand Rounds presented at SUNY Downstate Medical Center on May 18, 2018 Download powerpoint slides (. ppt): SUNY Grand Rounds CGRP and MOH. Lecture on Complementary and Alternative therapies for Headaches presented at the 28th Annual Practicing Physician’s Approach to the Difficult Headache Patient on February 18, 2018, in Carlsbad, CA. Download powerpoint slides (. ppt): CAM for headaches Diamond 2018 Renaissance Weekend lecture, October 18, 2014 Download powerpoint slides: Rennaisance 2014 Neurology Grand Rounds, Presented at the Rutgers Robert Wood Johnson Medical School, Department of Neurology on March 26, 2014 Download powerpoint slides: Magnesium and non-pharmacological therapies Neurology Grand Rounds presented at SUNY Downstate Medical Center on January 27, 2011. Download powerpoint slider (. ppt) Neurology Grand Rounds presented at the Weill Cornell Medical Center on September 19, 2007. Download powerpoint slides (. ppt) Neurology Grand Rounds presented at Dartmouth-Hitchcock Medical Center on May 25, 2006. Download powerpoint slides (. ppt) --- ### Testimonials & Feedback - Published: 2012-11-07 - Modified: 2021-01-09 - URL: https://nyheadache.com/testimonials-feedback/ Elie Wiesel was a Holocaust survivor, Nobel Peace Prize winner, writer, university professor, and a tireless campaigner for human rights. He spoke about his chronic daily headaches at a headache conference organized by Dr. Mauskop in 2008. Another patient we were able to help is Paul Shaffer, singer, actor, and multi-instrumentalist who served as David Letterman's musical director and band leader. Among our grateful patients (who gave us permission to reveal their names) is an American model and actress Stephanie Seymour   Other testimonials: Dear Dr. Mauskop, I saw the other headache specialist today for a consult about the Botox. It was a horrible appointment and reminded me of all the specialists I have seen in my life and how bad most of those experiences have been. I just wanted to say thank you.   I can’t say it enough really.   Thank you for being the kind of doctor that you are, for your brilliant contributions and work to the field, for being willing to do what other doctors aren’t smart enough to even think about, for not just accepting things the way they are, and for always doing the best for your patients. My life would be extremely different If it wasn’t for you, I would have no life at all. You truly have given me the gift of a worthwhile and meaningful life. Thank you a million times. LS   From 11-year-old Lucy: Dear Dr. Mauskop, I wanted to take a moment to thank you for your willingness for me... --- ### Educational Materials - Published: 2012-11-07 - Modified: 2024-06-03 - URL: https://nyheadache.com/educational-materials/ In addition to the older but still relevant articles listed on the right, Dr. Mauskop's blog contains up-to-date information on a variety of headache-related topics. It is regularly updated and contains more than 800 posts and more than 2,000 comments. The New York Headache Center offers transcranial magnetic stimulation (TMS) for a variety of neurological problems. We use an advanced neuronavigation system (Soterix) for the precise targeting of brain regions that need to be treated. TMS is administered by state-of-the-art equipment made by MagVenture. When we use fMRI to individualize TMS targeting, we use Omniscient Technology software to analyze fMRI scans. Neurologists frequently manage patients resistant to standard treatments. Some patients do not respond, cannot tolerate, or have contraindications to medications, Botox injections, supplements, and other therapies.   One promising treatment is transcranial magnetic stimulation (TMS). TMS is a proven procedure for anxiety, depression, obsessive-compulsive disorder (OCD), smoking cessation, and acute and preventive treatment of migraines. TMS utilizes magnetic fields to stimulate underactive nerve cells in the brain or reduce the excitability of overactive cells. TMS can change the flow of information between different parts of the brain in various neurological conditions. Published reports show the potential benefit of TMS in migraine, fibromyalgia, neuropathic pain, cluster headaches, facial pain, trigeminal and other neuralgias, back pain, insomnia, memory disorders, tinnitus, post-concussion syndrome, post-traumatic stress disorder (PTSD), stroke rehabilitation, restless leg syndrome, and long COVID. However, the evidence for the efficacy of TMS for these neurological disorders is still limited. The FDA... --- ### How Our Office Works - Published: 2012-11-07 - Modified: 2025-04-15 - URL: https://nyheadache.com/how-our-office-works/ Our locations: 30 East 76th Street (corner of Madison Avenue), 2nd floor, New York, NY 10021 (our building is old and while the office is wheelchair accessible, our bathroom is not). 2 Greenridge Avenue; the entrance is at 99 Maple Avenue (green awning), White Plains, NY 10605 (Only Dr. Mauskop sees patients at this location, usually, on the first Wednesday of the month). Our email is admin@nyheadache. com, but keep in mind that it is not HIPAA-compliant and after you are registered in our system, please use our patient portal www. myhealthrecord. com for all communications. If you do need to call, our telephone (for both locations) is 212-794-3550 (appointments, general questions, prior authorizations, & medical records – ext. 0, prescriptions – ext. 1, billing – ext 2, Botox-related – ext. 3) Fax: 212-794-0591. First Visit:  Your first visit will consist of a thorough diagnostic interview and examination, and your initial diagnosis will be discussed at its conclusion. Together we will design an individualized treatment program for you, to include the prevention of further attacks and tools to manage an acute headache. Please bring to your appointment your insurance card, physician referral form (if required), MRIs and other records, and the completed Initial Visit Form. You can download the Initial Visit form in a fillable PDF format, complete it, and email it to admin@nyheadache. com. If you are using Apple Preview or another non-Adobe program, choose Print from the File menu and then use the dialog box’s PDF option to... --- ### Address & Contact - Published: 2012-11-07 - Modified: 2021-10-04 - URL: https://nyheadache.com/address-contact/ Address & Contact Manhattan: 30 East 76th Street, New York, NY 10021 Tel: 212-794-3550 (appointments, general questions, prior authorizations, & medical records – ext. 0, prescriptions – ext. 1, billing – ext 2, Botox-related – ext. 3Fax: 212-794-0591 Email: admin@nyheadache. com Westchester: The building address is 2 Greenridge Avenue but the entrance is at 99 Maple Avenue (green awning), White Plains, NY 10605 Tel: 212-794-3550Fax: 212-794-0591 Email: admin@nyheadache. comClick here to see our location in google maps --- ### Home - Published: 2012-11-01 - Modified: 2025-04-15 - URL: https://nyheadache.com/   Welcome to the New York Headache Center Dr. Mauskop's latest book, The End of Migraines: 150 Ways to Stop Your Pain. has remained one of the best-selling books on migraines on Amazon. com since its publication in early 2021. The second expanded edition was published in October of 2022. 2025 is the 27th year Dr. Mauskop had been selected by his peers as a Castle Connolly Top Doctor. If you suffer from headaches, we can help. We offer a unique approach, which can be called integrative medicine. It is a combination of traditional medicine and methods variously categorized as functional, complementary or alternative therapies. Many of these complementary therapies and Botox injections help our patients achieve and maintain relief without the need for conventional medications, which are more likely to cause serious side effects. We also offer fMRI-guided transcranial magnetic stimulation (TMS), a non-pharmacological treatment of migraines and other neurological conditions with few side effects. We treat children and adults with chronic migraines, tension-type, cluster, and other types of headaches, post-concussion syndrome, cranial neuralgias, and facial pain. Treatments we provide in the office include nerve blocks, sphenopalatine ganglion (SPG) blocks, injections of sumatriptan, or intravenous treatments, such as magnesium, ketorolac (Toradol), metoclopramide (Reglan), Ondansetron (Zofran), dihydroergotamine (DHE-45), dexamethasone (Decadron), Vyepti, and others. We do not stock any opioid (narcotic) drugs. We also treat children with headaches. In children, we particularly emphasize safer, non-drug approaches. These may include biofeedback or meditation, magnesium, CoQ10, riboflavin, feverfew, other supplements, and Botox injections.... --- ### Welcome to the New York Headache Center - Published: 2012-11-01 - Modified: 2025-04-15 - URL: https://nyheadache.com/home-2/ Welcome to the New York Headache Center Dr. Mauskop's latest book, The End of Migraines: 150 Ways to Stop Your Pain. has remained one of the best-selling books on migraines on Amazon. com since its publication in early 2021. The second expanded edition was published in October of 2022. 2025 is the 27th year Dr. Mauskop had been selected by his peers as a Castle Connolly Top Doctor. If you suffer from headaches, we can help. We offer a unique approach, which can be called integrative medicine. It is a combination of traditional medicine and methods variously categorized as functional, complementary or alternative therapies. Many of these complementary therapies and Botox injections help our patients achieve and maintain relief without the need for conventional medications which are more likely to cause serious side effects.  We also offer fMRI-guided transcranial magnetic stimulation (TMS), a non-pharmacological treatment of migraines and other neurological conditions with few side effects. We treat children and adults with chronic migraines, tension-type, cluster, and other types of headaches, post-concussion syndrome, cranial neuralgias, and facial pain. Treatments we provide in the office include nerve blocks, sphenopalatine ganglion (SPG) blocks, injections of sumatriptan, or intravenous treatments, such as magnesium, ketorolac (Toradol), metoclopramide (Reglan), Ondansetron (Zofran), dihydroergotamine (DHE-45), dexamethasone (Decadron), Vyepti, and others. We do not stock any opioid (narcotic) drugs. We also treat children with headaches. In children, we particularly emphasize safer, non-drug approaches. These may include biofeedback or meditation, magnesium, CoQ10, riboflavin, feverfew, other supplements, and Botox injections. The... --- ## ## Posts ### Test title-3 - Published: 2013-07-19 - Modified: 2013-07-19 - URL: https://nyheadache.com/test-title-3/ - Categories: Uncategorized Test content-3 --- ### Test title-2 - Published: 2013-07-19 - Modified: 2013-07-19 - URL: https://nyheadache.com/test-title-2-2/ - Categories: Uncategorized Test content-2 --- ### Test title-1 - Published: 2013-07-19 - Modified: 2013-07-19 - URL: https://nyheadache.com/test-title-2/ - Categories: Uncategorized Test content-1 ---