Current Trends in the Medical Management of Hedaches: New Theories, targets and approaches

Headache is one of the most common medical complaints encountered by neuromuscular dentists and can be symptomatic of a distinct pathologic process or a serious underlying medical condition.

Advancement in headache pathophysiology over the last two decades has done much to demystify this condition and has created a legitimate pathophysiological understanding of this disorder. Despite this, Headache disorders remain one the most underdiagnosed and undertreated neurologic conditions today and continue to impose a substantial socioeconomic burden.

To ensure optimal patient care, the dental clinician must integrate knowledge of headache physiology with an understanding of therapeutic rationale. Novel therapeutic options continue to emerge that are supported by unique pharmacologic actions with which the savvy clinician must be familiar.

This presentation will explore the current theories underlying the pathophysiology of headache disorders and identify key features in their clinical presentation. A comprehensive review of scientific literature will identify treatments that have demonstrated efficacy in the management of these disorders. This program will conclude with an overview of recently identified therapeutic targets for migraine therapy along with findings reported for promising agents that are currently under development.

Learning Objectives

• Learn the diagnostic criteria for primary headache disorders including migraine, tension-type and cluster headaches
• Identify the red flags of headache diagnosis
• Discuss factors that precipitate migraine headache and strategies to avoid them
• State three key actions that are required for relief of a migraine headache
• Understand the association between migraine and the risk for myocardial infarction, stroke and death from cardiovascular disease
• Differentiate between symptomatic and preventative treatment for headache disorders and understand the potential danger of medication overuse
• Describe the treatment rationale for Triptans in the management of migraine and how they have catalyzed academic and pharmaceutical industry research
• Assess the efficacy of botulinum toxin type A (BOTOX) in the treatment of headache disorders
• Understand how vasoactive proteins play a central role in migraine propagation and how pharmacologic modulation of these proteins offer the promise of future treatment options for acute migraine attacks

Release date: Tue, June 14, 2011

Speaker: Manisha Patel

Dr. Manisha Patel received her Doctor of Dental Surgery degree from Northwestern University in Chicago and maintains a neuromuscular-based practice in cosmetic and reconstructive dentistry in New Hampshire. She is a Clinical Instructor at The Las Vegas Institute for Advanced Dental Studies and is a member of the board of directors for the International Association of Comprehensive Aesthetics (IACA).

Dr. Patel also holds a doctorate degree in Clinical Pharmacology from the Massachusetts College of Pharmacy and Health Sciences (MCPHS) where she graduated Summa Cum Laude. She presently serves on the faculty at MCPHS where she teaches neuropharmacology and applied pharmacokinetics to the doctoral students.

In addition, she serves on the medical staff at Concord Regional Hospital in New Hampshire where her expertise in critical care medicine and cardiology make her an integral part of an interdisciplinary team of clinicians who perform daily grand rounds. She is uniquely qualified at guiding physicians through the complexities of drug therapy in critically ill patients who receive intricate pharmaceutical regimens, have altered pharmacokinetic parameters, are prone to drug-drug interactions and have a high frequency of adverse drug events. As part of the health care team, her expertise is frequently solicited to assist physicians in pharmacotherapy decision making, monitoring patients for drug efficacy, furnishing drug and toxicology information and providing medical education to physicians and health care providers.

She has assayed papers for leading medical journals including The New England Journal of Medicine, Pharmacotherapy, The Journal of Clinical Pharmacology and The Annals of Internal Medicine.

She is the recipient of the Eli Lilly award for excellence in academic achievement and clinical research. She has helmed several investigational drug studies and clinical trials for the Federal Food and Drug Administration (FDA), the National Institute of Health (NIH) and pharmaceutical industries throughout the United States.