Headache Blog about conditions and treatments of headaches
Headache as a feature of Covid-19 Headache is common in patients with Covid-19. In the first review of the neurological aspects of Covid-19, a study of 214 patients in Wuhan with confirmed SARS-Cov-2 infection, Mao et al noted headache in 28 (13.1%) patients.(1) This figure has subsequently been replicated in a metanalysis of over 3000 … Read more
In previous blogs, I have described how calcitonin gene related peptide (CGRP) was found to be a lynchpin molecule in migraine, and how this led to the development of the new class of monoclonal antibody migraine treatments. I mentioned in passing that, in the early 2000s a new class of drug – the gepants – … Read more
Information continues to accrue on the potential neurological effects of infection with SARS-Cov-2, the virus that causes Covid-19. In the last few days, three papers have appeared detailing cases of acute inflammatory neuropathies associated with Covid-19. A paper in the New England Journal of Medicine presents five Italian patients with Guillain-Barré syndrome (GBS),(1) a condition … Read more
In a blog published yesterday, I summarised the current medical and scientific literature on the known or suspected direct neurological effects of SARS-Cov-2. It’s a fast-moving situation: in the last 24 hours the New England Journal of Medicine, perhaps the most prestigious general medical journal there is, has published a letter from a team of … Read more
There is as yet very little in the published literature on the neurological consequences of Covid-19 (the disease caused by infection with SARS-Cov-2). The first extensive report – a retrospective consecutive case series of 214 patients from Wuhan, China, with either moderate or severe COVID-19, was published in JAMA Neurology in early April 2020.(1) Of … Read more
Following the Government’s advice today to avoid all “non-essential” travel, I have made the decision to conduct all London Headache Centre consultations remotely until further notice. I will be very happy to review new and old patients via telephone, Skype, or other video conferencing methods. Consultation slots will continue to be available by contacting The … Read more
In the last blog, I told the story of the development of monoclonal antibodies (mAbs) against CGRP, from their first appearance in the literature in 2007 to their licensing in the USA and Europe in 2018-19. In the third blog in this sequence I will go into a little more detail on the evidence for … Read more
In the last blog, I took the CGRP story from the 1980s to the 2000s, from the fortuitous discovery of triptans to advent of monoclonal antibody technology, and the first inklings that it could be applied to the treatment of migraine. Useful drugs do not always start out as such. One transformation, seen time and … Read more
For the last 150 years, the understanding of migraine has oscillated between two poles: the vascular theory (that migraine is a disease of blood vessels and blood flow), and the neural theory (that migraine is first and foremost a brain disease). The first generation of truly effective acute migraine treatments – ergotamine and DHE – … Read more
I am employed by Buckinghamshire Healthcare NHS Trust for 10.5 PA (42 hours) per week. In addition to that I am engaged in private practice at BMI The Chiltern Hospital and The Medical Chambers Kensington. I have received honoraria in the last 10 years for advisory boards and lecturing from Novartis, TEVA Pharmaceuticals, Lilly, and … Read more