Jennifer S. Kriegler

Patent Foramen Ovale and Migraine: Closing the Debate--A Review.

A link between patent foramen ovale (PFO) and migraine as well as the utility of closure of PFO and its effect on migraine have been subjects of debate. The present review is an effort to gather the available evidence on this topic and formulate recommendations.

Long‐Term Outcomes and Clinical Characteristics of Hypnic Headache Syndrome: 40 Patients Series From a Tertiary Referral Center

Hypnic headaches (HHs) are unique because of late life onset and characteristic periodic nocturnal awakening. We retrospectively identified 40 cases at a tertiary headache referral center over the course of 6 years and assessed response to conventional treatments.

Menstrual Migraine and Treatment Options: Review

A review of treatment options for menstrual migraine.

Menstrual Migraine and Treatment Options—A Response

We appreciate the comments of Dr. Lichten. In our review, our intention was to illustrate clinical randomized controlled trials or clinical studies with statistically meaningful results. The review discusses the history, the physiology, and the treatment options pertaining to menstrual migraine. A portion of the review was dedicated to the efficacy and use of estrogen. We appreciate your comments regarding danazol. The article you referenced by Murray and Muse is a non-randomized prospective study involving five patients. Our review, on the other hand, focuses on randomized controlled trials involving enough patients to allow statistical analysis, specifically disproving the null hypothesis to achieve statistical significance. Monthly uterine bleeding can be reduced or eliminated using hormonal contraception with many types of hormonal agents. The efficacy of some other hormonal agents including danazol, norethindrone acetate (NETA), GnRH analogs (leuprolide), and progesterone receptor antagonists (mifepristone) are not only associated with significant side effects but are also more costly than triptans. Danazol, which suppresses pituitary follicle-stimulating hormone and luteinizing hormone, has androgenic side effects such as acne, hirsutism, and deepening of the voice, which limits its clinical use and makes it less practical in a young population. We did a cost comparison between sumatriptan and danazol. Generic sumatriptan comes in nine tablets in one packet, which has a range of cost between

Case Report of Debilitating Headaches and a Coexisting Ophthalmic Artery Aneurysm: An Indication for Treatment?

12.40 and

Detoxification or Wean Treatment of Opioids and Sedatives in Headache and Pain Disorders

65.25 at various pharmacies in the US. Per tablet it would cost at a minimum

Diagnosis of Addiction, Substance Use, and Headache

1.37. Generic danazol on the other hand, ranged between

Treatment and Consideration of Women’s Issues in Headache

144.05 at Walmart and

Drug‐Induced Headache (Advances in Applied Neurological Sciences; 5)

204.37 at Costco for 60 tablets; per tablet it would cost at a minimum

Neck and Arm Pain, 3rd Ed.

2.40 It is important to point out that treating menstrual migraine with abortive medications does not convert episodic migraine into refractory rebound tension-type headache. This statement is not supported by any literature.