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Smirnoff L, Pham K. A Role for Visual Art Therapy in the Management of Migraine. Curr Pain Headache Rep 2024; 28:189-194. [PMID: 38227211 DOI: 10.1007/s11916-023-01207-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/28/2023] [Indexed: 01/17/2024]
Abstract
PURPOSE OF REVIEW Migraine is a disabling disorder that adversely affects the whole person and requires multimodal management. Through a brief historical overview of migraine as a subject for visual art, benefits reported from art therapy used in the management of other types of chronic pain, and a summary of the limited research involving art therapy for migraine, we aim to provide support for art therapy's potential role in the management of migraine. RECENT FINDINGS As art therapy has been shown to be effective in the management of other chronic pain conditions, providing insight into the individual's pain experience and perception of pain, ameliorating pain by means of distraction, and improving psychosocial health, by extension, it may be of benefit in the migraine population as well. Migraine is disabling, and previous literature has shown efficacy in lifestyle modifications as well as complementary and alternative medicine. Based on its efficacy in other pain conditions, we suggest art therapy as an additional tool for the preventive management of migraine.
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Affiliation(s)
- Liza Smirnoff
- Headache Division, University of Miami Health, 1120 NW 14 Street, Suite 1346, Miami, FL, 33136, USA.
| | - Kendra Pham
- Division of Headache and Neuro-Ophthalmology, University of Utah, Salt Lake City, USA
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Moskatel LS, Smirnoff L. Headache and Dizziness after Roller Coaster Rides: A Case Series of 31 Patients. Can J Neurol Sci 2023; 50:914-917. [PMID: 36329659 DOI: 10.1017/cjn.2022.315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Previous literature on roller coaster injuries focuses on catastrophic injuries. We conducted a retrospective study of 31 adults with headache or dizziness after roller coaster rides. Twenty five of 31 (81%) patients presented with new or worsening headache, predominantly migraine (15/25, 60%), including 8/25 (32%) with chronic migraine. Of the chronic migraine patients, 4/8 (50%) already had the diagnosis and presented with an exacerbation. Five of the 25 (20%) were ultimately found to have a cerebrospinal fluid (CSF) leak. While persistent symptoms appear to be relatively rare, patients with chronic migraine and potential CSF leaks should consider skipping these attractions.
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Affiliation(s)
- Leon S Moskatel
- Division of Headache, Department of Neurology, Stanford Health Care, Palo Alto, CA, USA
| | - Liza Smirnoff
- Division of Headache, Department of Neurology, Stanford Health Care, Palo Alto, CA, USA
- Division of Comprehensive Neurology, Department of Neurology, Stanford Health Care, Palo Alto, CA, USA
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Bonilla H, Quach TC, Tiwari A, Bonilla AE, Miglis M, Yang PC, Eggert LE, Sharifi H, Horomanski A, Subramanian A, Smirnoff L, Simpson N, Halawi H, Sum-Ping O, Kalinowski A, Patel ZM, Shafer RW, Geng LC. Myalgic Encephalomyelitis/Chronic Fatigue Syndrome is common in post-acute sequelae of SARS-CoV-2 infection (PASC): Results from a post-COVID-19 multidisciplinary clinic. Front Neurol 2023; 14:1090747. [PMID: 36908615 PMCID: PMC9998690 DOI: 10.3389/fneur.2023.1090747] [Citation(s) in RCA: 24] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 02/06/2023] [Indexed: 02/26/2023] Open
Abstract
Background The global prevalence of PASC is estimated to be present in 0·43 and based on the WHO estimation of 470 million worldwide COVID-19 infections, corresponds to around 200 million people experiencing long COVID symptoms. Despite this, its clinical features are not well-defined. Methods We collected retrospective data from 140 patients with PASC in a post-COVID-19 clinic on demographics, risk factors, illness severity (graded as one-mild to five-severe), functional status, and 29 symptoms and principal component symptoms cluster analysis. The Institute of Medicine (IOM) 2015 criteria were used to determine the Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) phenotype. Findings The median age was 47 years, 59.0% were female; 49.3% White, 17.2% Hispanic, 14.9% Asian, and 6.7% Black. Only 12.7% required hospitalization. Seventy-two (53.5%) patients had no known comorbid conditions. Forty-five (33.9%) were significantly debilitated. The median duration of symptoms was 285.5 days, and the number of symptoms was 12. The most common symptoms were fatigue (86.5%), post-exertional malaise (82.8%), brain fog (81.2%), unrefreshing sleep (76.7%), and lethargy (74.6%). Forty-three percent fit the criteria for ME/CFS, majority were female, and obesity (BMI > 30 Kg/m2) (P = 0.00377895) and worse functional status (P = 0.0110474) were significantly associated with ME/CFS. Interpretations Most PASC patients evaluated at our clinic had no comorbid condition and were not hospitalized for acute COVID-19. One-third of patients experienced a severe decline in their functional status. About 43% had the ME/CFS subtype.
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Affiliation(s)
- Hector Bonilla
- Department of Medicine, Stanford University, Stanford, CA, United States
| | - Tom C Quach
- Department of Medicine, Stanford University, Stanford, CA, United States
| | - Anushri Tiwari
- Department of Medicine, Stanford University, Stanford, CA, United States
| | - Andres E Bonilla
- Department of Molecular, Cell and Developmental Biology, University of Michigan, Ann Arbor, MI, United States
| | - Mitchell Miglis
- Department of Medicine, Stanford University, Stanford, CA, United States
| | - Phillip C Yang
- Department of Medicine, Stanford University, Stanford, CA, United States
| | - Lauren E Eggert
- Department of Medicine, Stanford University, Stanford, CA, United States
| | - Husham Sharifi
- Department of Medicine, Stanford University, Stanford, CA, United States
| | - Audra Horomanski
- Department of Medicine, Stanford University, Stanford, CA, United States
| | - Aruna Subramanian
- Department of Medicine, Stanford University, Stanford, CA, United States
| | - Liza Smirnoff
- Department of Medicine, Stanford University, Stanford, CA, United States
| | - Norah Simpson
- Department of Medicine, Stanford University, Stanford, CA, United States
| | - Houssan Halawi
- Department of Medicine, Stanford University, Stanford, CA, United States
| | - Oliver Sum-Ping
- Department of Medicine, Stanford University, Stanford, CA, United States
| | | | - Zara M Patel
- Department of Medicine, Stanford University, Stanford, CA, United States
| | | | - Linda C Geng
- Department of Medicine, Stanford University, Stanford, CA, United States
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Moskatel LS, Smirnoff L. Protracted headache after COVID‐19: A case series of 31 patients from a tertiary headache center. Headache 2022; 62:903-907. [PMID: 35670231 PMCID: PMC9348335 DOI: 10.1111/head.14337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 05/04/2022] [Accepted: 05/06/2022] [Indexed: 12/01/2022]
Abstract
Background Headache can be a prominent feature of Post‐Acute Sequelae of SARS‐Cov2 infection (PASC) and previous studies have centered around PASC headaches that have resolved within a month of infection. Methods We performed a retrospective chart review of 31 adults evaluated at the Stanford Headache Clinic between September 2020 and January 2022 who developed new or worsening headaches after COVID‐19 infection that were unresolved at time of evaluation for demographics, medical history, and headache diagnosis. Results Headache had been present for a mean duration of 7.4±4.8 months after infection. Notably, 25/31 (81%) had a previous history of headache. The specific features of the headache varied considerably, but 23/31 (74%) met International Classification of Headache Disorders, Third Edition (ICHD‐3) criteria for migraine, with 20/31 (65%) meeting ICHD‐3 criteria for chronic migraine, while only 5/31 (16%) met these criteria before COVID infection. Additionally, full‐time employment decreased from 25/31 (81%) to 17/31 (55%). Prior to establishing care at our clinic, 13/18 (72%) of the patients who were started on preventive medications currently indicated for migraine management, reported a decrease in frequency and/or severity of headaches. Conclusions Our study presents a group of patients with protracted headache after COVID‐19 infection that includes both patients with a previously lower headache burden who largely exhibited chronification from episodic to chronic migraine, as well as patients with no previous history of headache who meet ICHD‐3 criteria for headache attributed to a systemic viral illness, mostly with a migrainous phenotype.
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Affiliation(s)
- Leon S. Moskatel
- Division of Headache, Department of Neurology Stanford School of Medicine Palo Alto California USA
| | - Liza Smirnoff
- Division of Headache, Department of Neurology Stanford School of Medicine Palo Alto California USA
- Division of Comprehensive Neurology, Department of Neurology Stanford School of Medicine Palo Alto California USA
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