Nerivio Migra, NOW AVAILABLE AT MCHN! 1st Smartphone controlled acute migraine-relief wearable device!

The FDA granted a de novo request for approval of a smartphone-controlled electroceutical for the acute treatment of migraine with or without aura in adult patients who do not have chronic migraine. The Nerivio Migra is a wearable device that goes on the upper arm and this device is controlled from your smartphone.
It was invented by Theranica, an Israeli company, with the goal of relieving migraine pain without the side effects of medication.
Nerivio Migra is the 1st FDA approved low cost, low side effect wearable device for the acute treatment of migraine.
The Nerivio Migra has 2 electrodes on the inside of the arm band.
Through a patient’s smartphone, it generates electrical impulses, sending them to the brain to release the body’s own painkillers to the nerves.
Similar to a nicotine patch, you place the Nerivio Migra device on your arm above the elbow. The device communicates wirelessly via Bluetooth with your smartphone, which regulates the electrical pulses and sets a timer. A 45-minute treatment can bring relief for pain within two hours.

In tests, 66.7% of the 252 migraine sufferers in 13 clinics felt relief after 2 hours, compared to 28% of those using a placebo, or dummy device.

Call and speak to one our providers to learn more about this revolutionary device. We are one of the very few neurology practices providing demonstrations! We are very excited about Nerivio Migra and look forward to seeing you!

What is Trigeminal Neuralgia?

Trigeminal neuralgia is a chronic pain condition that affects the trigeminal nerve, also known as the 5th cranial nerve. The trigeminal nerve consists of three branches that conduct sensations to the brain from the upper, middle, and lower portions of the face, as well as the oral cavity. Trigeminal Neuralgia is caused by a variety of conditions resulting in pressure, compression or injury to the trigeminal nerve.
Typical presentation is characterized by an extreme, sudden burning, or shock-like facial pain, lasting seconds to two minutes per episode. These attacks can occur in quick succession. Atypical presentation is characterized by a more constant sensation of pain that tends to be slightly less severe than the typical presentation. Both typical and atypical presentation of pain may occur in the same person and potentially at the same time. The intensity of pain can be physically and mentally debilitating.
The intense flashes of pain can be triggered by contact, or even light touch. For example, daily activities such as shaving, washing the face, applying makeup, brushing teeth, eating, drinking, talking and even being exposed to the wind can trigger pain.
Treatment options include medicines, surgery, and alternative therapy. Come see us for an evaluation if you are experiencing any of these symptoms, we can find the right treatment for you!

Caroline Pruski, NP


Tracking headaches

Keeping track of your symptoms can be very helpful for several reasons. First, it is a tool to help your provider find the right treatment for you. Also, it is helpful for you to determine what is causing the headaches or migraines. By keeping track of activities, foods eaten, and stressors prior to getting the headache, it will make it easier to know what to avoid in the future.
For example, some people find that eating specific foods may trigger a migraine.

Additionally, some people find a pattern of headaches that may be associated with a certain time of the day or day of the week.

You may track your headaches using the calendar on your cell phone, a paper journal, or one of many headache tracking apps such as iHeadache.

For more information about tracking your headaches and using the information you recorded to guide your care, call The Manhattan Center for Headache & Neurology. We look forward to seeing you!

By: Brooke Steiger, NP

Migraine and Pregnancy

Migraine is especially common in women of reproductive age. There are many treatments available for migraine that are highly effective but common questions I get from patients who fall into this population include:
What am I going to do when I am trying to get pregnant, am pregnant, or breast feeding?
Will I have to stop my current treatment that has been working so well?
What are the fertility risks associated with migraine treatment during this time?

Don’t worry, we will find an individualized treatment plan for you! Another reason not to worry is the fact that for most women, pregnancy and breast feeding after pregnancy is protective against migraine. Approximately 47% of women have improvement in their migraines during their 1st trimester, 83% during their 2nd trimester and 87% during their 3rd trimester. Essentially for most women, the rate of remission from migraines increases as the pregnancy progresses.

Even if your migraines don’t improve during your pregnancy there are still options for you, such as:
Non-pharmacological behavioral changes and approaches can help decrease the frequency and severity of migraines. For example: rest and relaxation techniques, biofeedback, behavioral sleep modification, prenatal yoga.
Supplements and minerals are safe during pregnancy and are shown to improve migraine. Supplements include: Riboflavin, Vit B2, CoQ10, and Magnesium.
Acetaminophen (Tylenol) is safe to use in all trimesters as an abortive while pregnant
Metoclopramide (also known as Reglan) is an ant-nausea medication that is safe during all trimesters, can help with the nausea associated with migraines and the nausea associated with pregnancy (hyperemesis gravidarum)
Occipital and trigeminal peripheral nerve blocks (preferably done with just lidocaine) can be given when pregnant
Neuromodulation devices

By: Caroline Pruski, NP


Caffeine is a stimulant substance found in items such as coffee, tea, and chocolate.
It is a known trigger for migraine sufferers. Some people are more sensitive than others to the effects of caffeine consumption and this can be very different from individual to individual.
In addition to triggering migraines, caffeine can cause dehydration. It is important to replace any water lost from caffeine consumption. For instance, if you drink 1 cup of coffee, then drink two 8 ounce glasses of water.
Keep in mind that in some people, headaches are triggered by caffeine withdrawal. For example, if you drink coffee during the weekdays, you may experience a withdrawal headache on the weekend.
For more information about lifestyle changes that may help you to decrease migraines and headaches, call The Manhattan Center for Headache & Neurology to speak with one of our caring providers. We look forward to seeing you!

By: Brooke Steiger, NP


Sleep is vital to help you maintain overall health. Many people who get migraines notice that they may experience more migraines when they are fatigued or haven’t slept well.
Make sleep a priority! It is recommended that you get 7-8 hours of sleep per night. Keeping a consistent bedtime and wake time is also an important part of a healthy sleep routine.
Creating a bedtime routine is another self-care habit that is part of setting yourself up for a good night’s sleep. You may consider taking a bath with essential oils, practicing meditation, or reading a good book as part of this routine.
It is also vital to maintain good sleep hygiene. This means turning off electronics for 1 hour prior to going to bed, not eating and drinking close to your bedtime, and avoiding alcohol near bedtime.
For more information about how sleep and other lifestyle changes can help your migraines, call The Manhattan Center for Headache & Neurology and speak to one of our caring providers!

By: Brooke Steiger, NP

Riboflavin for Headaches

Riboflavin is also known as vitamin B2 and is a B vitamin normally found in foods such as eggs, milk, poultry, green vegetables, and liver. It is involved in many cellular processes in the body, including the conversion of food into energy. It is sold as a natural supplement and is a safe and inexpensive option to be used for the prevention of migraines. It is common to see riboflavin included as part of a multi-component supplement that is specifically labeled for migraine prevention.

It has been shown to reduce the frequency of migraines. In one study, riboflavin supplementation helped reduce the frequency of migraines. Other studies have found a decrease in the use of migraine medications after several months of daily riboflavin supplementation. It is important to take this supplement at the correct dosage for it to be beneficial.

Call The Manhattan Center for Headache & Neurology to speak to one of our providers about adding riboflavin to your daily regimen!



There’s an App for That

We are all so connected these days. Migraine specialists at NYU have taken advantage of that fact to develop an app for smartphones to help patients suffering from migraines. The app is called RELAXahead and it uses behavioral and relaxation techniques to help patients manage their headaches. The study of migraine patients using the app found that after 2 months of use, those who used it 2 days per weeks had 4 fewer headache days per month. The app is especially helpful for patient’s to manage their headaches who have fewer choices of pharmacologic therapy such as pregnant and nursing mothers.

You can download the app from the Apple App Store or Google Play App Store.

By: Brooke Steiger

Magnesium and Headaches

Magnesium is one of the most abundant minerals found in the body that controls many important processes within our cells. It plays a vital role in the proper functioning of our nerves and muscles.

Some studies have shown a connection between low blood magnesium levels and chronic migraines and headaches. Other studies have found a significant decrease in symptoms associated with migraines including sensitivity to light and sound.

For this reason, your provider may recommend magnesium supplementation in pill form or via IV infusion to help control your migraines.

For more information please call our office to schedule an appointment with one of our caring providers. We look forward to meeting you!

By: Brooke Steiger, NP

Procedure spotlight: SPG block

SPG stands for sphenopalatine ganglion. It describes a group of nerve cells connected to the trigeminal nerve that is located behind the bony structures of the nose that is associated with headache and migraine. This in office procedure takes less than 5 minutes and uses a small plastic tube inserted in the nose to deliver local anesthesia to the SPG to help stop the pain signaling that causes the headache or migraine. Risks and side effects are minimal and temporary but may include mild discomfort, bitter taste in mouth, and lightheadedness.

Please call the office to schedule your consultation and discuss this procedure with your provider.

By: Brooke Steiger, NP