Headache and Migraine in Later Life

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Key Questions
  • What are the most common headache disorders in people over the age of 50?
  • How does migraine typically change in middle and older age?
  • Is it true that migraine improves with age?
  • Are triptans still safe for the older population with migraine?
  • How common is it for an older person to get a new diagnosis of migraine?
  • In someone with a history of migraine, what are some factors that might lead to increased frequency of attacks in middle age?
  • What are some alternatives if triptans either stop working for someone, or become unsafe to use?
  • How safe are some of the typical migraine medications for people older than 50?
  • Why do some people with migraine become more or less responsive to their usual medications as they age?
  • What are the risks of a long-term migraine history and the long-term medication use that may accompany it?
  • Are the newer medications safe for older people with migraine?
  • What nonmedicinal options exist for migraine after 50 years of age?
Interview Notes

Matthew Robbins, MD

Associate Professor of Neurology and Residency Program Director
Weill Cornell Medicine, New York-Presbyterian Hospital

Matthew S. Robbins, M.D., is the program director for the neurology residency and an associate professor of neurology at Weill Cornell Medicine and New York-Presbyterian Hospital. His clinical practice focuses on patients with migraine, cluster headache, new daily persistent headache, other headache disorders, CSF (cerebrospinal fluid) leaks, and visual snow. He has experience with patient care, teaching, and research for headache disorder treatments, including monoclonal antibodies, procedures such as botulinum toxin injections and peripheral nerve blocks, and neuromodulation devices. Dr. Robbins developed an academic career integrating patient care, education and mentorship, research, and advocacy for people with headache and other neurological conditions.

Previously, Dr. Robbins earned his B.S. from Yale University and his M.D. from SUNY-Downstate College of Medicine. He completed his neurology residency at the Albert Einstein College of Medicine/Montefiore Medical Center, where he was also a chief resident and then a Fellow in Headache Medicine at the Montefiore Headache Center. He served on the faculty at Montefiore-Einstein for nearly a decade, where he was an associate professor of neurology, chief of neurology at the Jack D. Weiler Hospital, and director of inpatient services for the Montefiore Headache Center.

He serves as president-elect of the New York Neurological Society and on the board of directors of the American Headache Society. In addition, he is passionate about advocacy, and is a graduate of the Palatucci Advocacy Leadership Forum of the American Academy of Neurology.

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