Migraine Long Haulers: Lasting Effects

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Key Questions
  • How does migraine most typically morph over time when someone has lived with it for decades?
  • What concerns should we have about the effects of long-term migraine on our health outside of migraine attacks themselves: Are changes to brain structure or function likely? Are these changes permanent or can they be reversed, for instance, if you manage to reduce your attack frequency?
  • What is known about the long-term trajectory of migraine?
  • What do we know about the common “white-matter” abnormalities found in MRI scan results in people with migraine? What do they mean? Should we be concerned?
  • What other health conditions or associations should people with long-term migraine look out for?
  • Are there any opportunities to address other conditions that are comorbid with migraine using the same medication?
  • What happens when treatments that have worked for patients stop working?
  • When a new type of headache presents or a medication responsiveness changes, in what circumstances should there be an evaluation?
  • Are there risks or concerns with long-term migraine medication use?
    Is there a safety risk of using CGRP medications long-term?
Interview Notes

Find out more about Matthew Robbins, MD and his work here:

Treatments Mentioned
  • Amitriptyline
  • Beta blockers
  • Botulinum toxin
  • CGRP
  • Cognitive behavioral therapy (CBT)
  • Erenumab
  • Exercise/nutritional program
  • Topiramate
  • Tricyclic antidepressants
  • Nortriptyline
  • Sleep hygiene

Please note: The Migraine World Summit’s aim is to bring you a variety of perspectives and expertise, independent of bias or judgment. Alternative theories presented in this video have not been medically reviewed. Views expressed in this interview do not necessarily represent the views of the Migraine World Summit. Please always consult your health care professional and do your own research before making changes to your treatment plan.

Matthew Robbins, MD

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

Dr. Matthew Robbins completed his BS from Yale University, his MD from SUNY Downstate College of Medicine, and his neurology residency and headache fellowship at the Albert Einstein College of Medicine/Montefiore Medical Center, where he remained on faculty for nearly a decade. In 2018 he joined the department of neurology at Weill Cornell Medicine/New York Presbyterian Hospital as the neurology residency program director and associate professor of neurology. For the American Headache Society (AHS), he is the secretary on the executive board, directs all resident education programming, and is a Resident and Fellows Section editor for Headache.

He has won the Members’ Choice award for the best publication in Headache, the Above and Beyond Award from the AHS, and an A.B. Baker Teacher Recognition Award from the American Academy of Neurology (AAN). He has led organizational initiatives related to headache, including guidelines and quality measures. He is a graduate of the Palatucci Advocacy Leadership Forum of the AAN, where he has also served as an advisor.

Dr. Robbins regularly presents at national and international meetings and has published widely on topics including headache procedures, headache in pregnancy and the elderly, cluster headache, new daily persistent headache, unusual forms of migraine aura, and neurologic education.

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Over the past 50 years, our mission at the National Headache Foundation has been to further awareness of headache and migraine as legitimate neurobiological diseases. Much has changed during this time. With aid from advanced technology and clinical innovation, there are more treatment options than ever before. However, we understand that these diseases are still largely misunderstood and that finding the right treatment options for you requires insight.

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