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AAN 2023 | Comprehensive approach to migraine management: collaboration & holistic care

Nina Yakovlevna Riggins, MD, FAAN, from the University of California, San Francisco, CA, emphasizes the importance of working closely with students and fellows to ensure that no crucial aspects are missed in the management of migraines. She discusses how addressing triggers for migraines and secondary headaches can greatly contribute to comprehensive patient care. During AAN, she highlighted the significance of collaboration between sessions, such as sleep and sports sessions, in understanding and managing post-traumatic headache. Taking a careful history, documenting everything in a headache diary, and addressing all aspects of a patient’s condition holistically can help improve patient well-being and functionality in the face of post-traumatic headache. Dr. Riggins underscores the availability of numerous innovative devices for migraine treatment. She advocates for a holistic approach to addressing sleep-related issues in patients, as sleep disturbances can often exacerbate migraines. Additionally, she discusses the concept of medication overuse headache and the importance of addressing this condition to effectively treat migraines, particularly in individuals who may be genetically predisposed to migraines and are taking medication for other reasons, such as post-traumatic injury. Another area of focus in Dr. Riggins’ presentation is the impact of hormonal changes on migraines, particularly in relation to women’s health. She highlights the need for further research and understanding of gender differences in migraines, including the influence of hormonal fluctuations throughout a woman’s lifespan. Dr. Riggins references sessions at AAN where discussions were held on migraines and women’s health. She provides insights into the effects of oxytocin, estrogen, and magnesium on women’s health, menstrual cycles, and migraines, emphasizing the importance of conducting more studies in this complex area. Overall, Dr. Riggins stresses the significance of holistic patient care, collaboration between different specialties, addressing post-traumatic headache, managing sleep-related issues, and understanding the impact of hormonal fluctuations on migraines in women. This interview took place at the American Academy of Neurology Annual Meeting in 2023 in Boston, MA.

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