Category Archives: Uncategorized


In these uncertain times, it is more important than ever to do our best to take care of our mental health.

Anxiety is a feeling of unease that may lead to panic attacks and may even manifest in physical symptoms such as heart palpitations and chest pain.

Good coping strategies are more important than ever. Listed below are a few ways to help maintain good mental health hygiene.

-Get up and get moving:
Exercising and moving your body is a proven method for managing anxiety. There are many new streaming platforms for at home workouts available some of which are free. Also stretching and yoga is a great option, and even has been proven for people managing anxiety and headaches.

Meditation has several proven benefits including helping to quiet the mind. There has also been studies showing that it’s beneficial for people with headaches. If this seems intimidating, just start with five minutes in the morning and try using a guided meditation app.There are many apps available for Free or low-cost including headspace.

-Stay in touch:
While it is extremely important to follow the social distancing guidelines to prevent further spread of COVID-19, it is important not to become socially isolated. Communicate with your friends and family via phone or video chat. You can even get creative and plan virtual dinners or even try a virtual book club.

-Eat healthy:
As anxiety has increased, it becomes Difficult not to succumb to comfort-eating. Do your best to prepare healthy meals with lots of vegetables and fruit. Frozen vegetables and fruit are a great option to supplement your meals. A balanced diet will keep you feeling good and, as we know a healthy body is a healthy mind.

-Ask for help:
If you feel like you’re not able to manage your anxiety or depression on your own, ask for help. Many mental health counselors are available via telehealth visits. Also, free resources for counseling available is for New York City metropolitan area residents via a 24/7 hotline at 1-888-NYC-WELL (1-888- 692-9355) and via the website you can chat with a trained mental health counselor.

Also, keep in mind that MCHN is available 9am -5 pm Monday through Friday for Telehealth visits to help you manage your headaches and symptoms.

Stay well!

Brooke Steiger, NP

Coronavirus (COVID – 19) – Social Distancing & Updates from MCHN

There are different types of human coronaviruses, 15-30% are the cause of the common cold. COVID – 19 is a new disease, cause by a novel or new coronavirus that has not previously been seen in humans. This coronavirus is thought to spread from person-to person through respiratory droplets.
The best way to prevent this illness and to prevent its spread is social distancing. For an individual, social distancing means maintaining at least 6 feet of distance or more between yourself and others. Additionally, social distancing means canceling large events, closing schools, canceling meetings and staying home.
The ultimate goal with practicing social distancing is to “flatten the curve”, to reduce the number of people that get infected and reduce how quickly it this virus spreads so the health care system doesn’t get overwhelmed. If the curve is steep, the virus is spreading at an exponential rate and the total number of cases skyrockets in a short period of time. The faster the infection curve rises, the quicker the local health care system gets overloaded beyond its capacity to treat people. A flatter curve, on the other hand means a slower infection rate which results in a less stressed health care system and fewer people getting the virus.

Here at the Manhattan Center for Headache and Neurology our patients are still our priority during this time. The following includes updates of what our practice is implementing to make sure our patients still get the proper care they need, while being safe and while continuing to “flatten the curve”.
Instead of coming into the office you can schedule a “Telehealth” appointment and meet with your provider virtually. “Telehealth” is being offered for all existing and new patients and is covered by insurance.
We are screening all patients and asking patients who have any COVID-19 symptoms or recent travel aboard to not come in and schedule a “Telehealth” appointments instead.
Starting next week there will be a reduced number of providers and staff in the office for in person appointments and testing. The rest of the staff will be working from home and virtually available.
Starting next week the office will have slightly altered business hours of operation. We will be open from 9 am to 5 pm, Monday – Friday.
Our office is following proper infection control standards and carrying out a no contact/no handshake policy.
Hand sanitizing stations will be available at the door and throughout the office.
Call or email our office for any prescription refills and consider having them sent to pharmacy that offers delivery. Try utilizing companies such as NowRx, Capsule, and Express Scripts to avoid a trip to the pharmacy. Also, check and see if your CVS or Walgreens is one of the locations practicing in their new delivery program.

Caroline Pruski, NP


Caffeine is a stimulant compound found naturally in coffee and tea. It is often associated with either triggering or relieving headaches or migraines.

During a headache, blood vessels become enlarged and become stretched and painful. Caffeine is thought to help relieve headaches by causing constriction of blood vessels which can reduce pain.

A recent study in the American Journal of Medicine showed increased likelihood of migraines on days when participants drank more than 3 or more cups of coffee. The study took into account stress levels, sleep, alcohol intake, and menstrual cycle on the day.

It is important to keep in mind that caffeine is a diuretic, meaning it can cause dehydration which can also be a trigger for headaches.

Overall, drinking 1-2 small cups of coffee per day is usually not a problem for people who suffer from headaches and migraines but more than that would not be recommended. Most importantly, each individual is a little different so caffeine may affect one person differently than another.

If you have additional questions about caffeine and headaches, talk to your healthcare provider.

Brooke Steiger, NP


In an effort to ensure our patients health and due to recent health advisories, The Manhattan Center for Headache and Neurology will offer telehealth appointments to all of our established patients. If you have a cough, fever, and have traveled abroad please call the center to schedule a virtual visit. We will do everything that we can to make sure that you have your neurological needs met. Call us for more details.

We are also offering Telehealth Consultations. Please review our Telehealth Appointments Menu. It is now available via our Microsoft online schedule for patients.

Cluster headaches

There are several types of primary headaches. One of them is cluster headache. It is a relatively rare type of headache disorder that is characterized by headaches of short duration that may occur up to 8 times per day.

Usually headaches last anywhere from about 15 minutes to 3 hours long and cause severe pain. Generally people also have other symptoms during their attacks including nasal congestion or runny nose, redness or tearing of the eyes, drooping eyelids, or swelling of the face on the same side as the headache.

People with cluster headaches may experience headaches that may last for months and then resolve. Some people with chronic cluster headaches may go years without headache attacks.

If you think you may suffer from cluster headaches, talk to your healthcare provider regarding treatment options.

Brooke Steiger, NP

FDA approves Lundbeck’s Vyepti™ (eptinezumab-jjmr) – the first and only intravenous preventive treatment for migraine

On February 21, 2020, the FDA approved eptinezumab-jjmr (VYEPTI™) for the preventive treatment of migraine in adults. This is the first intravenous (IV) treatment for migraine prevention and the latest in a new class of monoclonal antibodies used for the preventive treatment of migraine.

Eptinezumab is a humanized monoclonal antibody that binds to calcitonin gene-related peptide (CGRP) ligand and blocks its binding to the receptor. The drug is expected to launch commercially in April of 2020 and should be administered every three (3) months via a 30-minute IV infusion.

This is yet another very exciting development for people living with migraine.

Call The Manhattan Center for Headache & Neurology to learn more about Vyepti. Let us help you lead a pain free life!


Biohaven’s NURTEC™ ODT (rimegepant) Receives FDA Approval for the Acute Treatment of Migraine in Adults
– First and only calcitonin gene-related peptide (CGRP) receptor antagonist available in a fast-acting orally disintegrating tablet (ODT)
– A single oral dose of NURTEC ODT 75 mg can provide fast pain relief and return patients to normal function within one hour, and deliver sustained efficacy that lasts up to 48 hours for many patients
– 86 percent of patients treated with a single dose of NURTEC ODT did not use a migraine rescue medication within 24 hours

Call The Manhattan Center for Headache & Neurology to learn more about Nurtec! Let us help you lead a pain free life!

Migraine Supplements and Supplement Regulation

There has been a growing interest and demand for “natural treatments” such as vitamins to help treat migraine. The most commonly recommended vitamins for migraine include Magnesium, Riboflavin (Vitamin B2), and Coenzyme Q10 (CoQ10). Multiple statistically significant studies display that these vitamins reduce the frequency and intensity of migraines. Doses for each vitamin include 400 to 500 mg of magnesium, 400 milligrams of vitamin B-2 and 100 mg of CoQ10.
Cautions with supplements:
· Rules for manufacturing and distributing dietary supplements are less strict in comparison to prescription or over-the-counter drugs.
· Dietary supplements only undergo post-market regulation. The FDA is not authorized to review dietary supplements for safety and effectiveness before they are marketed, only after the product is on the market can the FDA take action against adulterated or misbranded dietary supplements only after the product is on the market.
· Dietary supplements may interact with other medications or be contraindicated with certain medical conditions.
· What’s on the label may not be what’s in the product. For example, prescription drugs have been found in products being sold as dietary supplements.
· Supplements with false claims. Many times there is no supporting research or contraindicating research results for supplement use with certain medical conditions.
Consumer Strategies:
· Read the label carefully. In many cases, ingredients that are banned or harmful are listed in the label.
· Check to see if your supplements have gone through third party testing. Many supplement products bear logos demonstrating that they have voluntarily enrolled in third-party testing programs.
– Caroline Pruski, NP