The CNR’s Section for Headache and Facial Pain is one of the largest and most comprehensive centers in the world dedicated towards managing and treating headache and facial pain. We have collected and published data documenting our treatment outcomes for over a decade. This data is used to continuously review our treatment practices to ensure the highest level of care for our patients. Our outcomes research evaluates patient reported measures including improvement after treatments such as Onabotulinumtoxin A (Botox) intravenous infusions for headache. In addition, the Headache Reboot program, a comprehensive and multidisciplinary outpatient program for chronic headache patients who have exhausted other treatment options, may be an option for patient struggling with good headache control. The Cleveland Clinic also offers an 8 week, weekly virtual visit (telemedicine) appointments for patients who may have time constraints but are still will to meet with a medical provider for tailored multi-modal treatment options.
In addition, CNR’s Headache Physicians remain at the forefront of treating migraine with novel therapies. We maintain a large array of treatment options tailored specifically for each individual patient with headache. Our expertise ranges from the use of monoclonal antibodies against Calcitonin Gene Related Peptides to neuromodulation and nutraceuticals. Our participation and development of clinical trials evaluating these therapies fosters the innovation necessary to treat patients with refractory headaches who have failed more common therapies. Currently these trials include evaluating monoclonal antibodies for the treatment of cluster headache and migraine, as well as novel devices including non-invasive vagus nerve stimulators and neuromodulators for headache.
Zubair Ahmed, MD
A 69-year-old woman with diplopia and lower extremity weakness. Migdady I, Mays MA, Levin KH. Cleve Clin J Med. 2019 June;86(6):374-379. doi:10.3949/ccjm.86a.18113.
Restricted Diffusion MRI Lesions in HIV-Associated CMV Encephalitis. Cho SM, Mays MA. Neurohospitalist. 2018 Jan;8 (1):NP3-NP4. doi: 10.1177/1941874417698325. Epub 2017 Mar 10. PMID: 29276568.
Mentored peer review of standardized manuscripts as a teaching tool for residents: a pilot randomized controlled multi-center study. Wong VSS, Strowd RE, Aragón-García R, Park Moon Y, Ford B, Haut, SR, Kass JS, London ZN, Mays MA, Milligan AT, Price RS, Reynolds PS, Selwa LM, Spencer DC, Elkind MS. Research Integrity and Peer Review. 2017 Jun 5; 2:6. doi: 10.1186/s41073-017-0032-0. eCollection 2017. PMID: 29451555.
Acute paraparesis and sensory loss following intravenous corticosteroid administration in a case of longitudinally extensive transverse myelitis caused by spinal dural arteriovenous fistula: case report and review of literature. DiSano MA, Cerejo R, Mays M. Spinal Cord Series and Cases. 2017 May 18; 3:17025.
Calcitonin Gene Related Peptide Antagonists for the treatment of headache disorders. Bucklan J. Ahmed ZA. Review. Cleveland Clinic Journal of Medicine. In Press.
Patients with Migraine have Substantial Reductions in measures of Visual Quality of Life. Hanson LL, Ahmed Z, Katz BJ, Warner JEA, Crum AV, Zhang Y, Zhang Y, Baggaley S, Pippitt K, Cortez MM, Digre KB. Headache. 2018. Jul;58(7):10007-1013.
Sarcoidosis-associated Small Fiber Neuropathy in a Large Cohort: clinical aspects and response to IVIG and anti-TNF alpha treatment.Tavee J, Karwa K, Ahmed Z, Thompson N, Culver DA. Respiratory Medicine. May 2017.126:135-138.
Safety and Efficacy of Occipital Nerves Stimulation for the Treatment of Chronic Migraines: Randomized, Double-blind, Controlled Single-center Experience. Pain Pract. 2017 Jun;17(5):669-677. Mekhail NA, Estemalik E, Azer G, Davis K, Tepper SJ.
Do providers discuss the Relationship between Sleep and Headache Prior to Consultation with a Headache specialist? 59th Annual American Headache Society Meeting, Boston, MA June 2017.Michael, Rebecca MD, Hogue, Olivia MPH, Kriegler, Jennifer S MD.
A Prospective Cohort Study of Outpatient Interdisciplinary Rehabilitation of Chronic Headache Patients. Headache. 2017 Mar;57(3):428-440. Krause SJ Stillman MJ, Tepper DE, Zajac D.
An Algorithm for Opioid and Barbiturate Reduction in the Acute Management of Headache in the Emergency Department.. Headache. 2017 Jan;57(1):71-79. Ahmed ZA, Nacopoulos DA, John S, Papesh N, Levine D, Bamford CC
The Effectiveness of Aromatherapy in Reducing Pain: A Systematic Review and Meta-Analysis Pain Res Treat. Dec 2016;1-13 SE, Sheafer H, Tepper D.
Long-Term Outcomes and Clinical Characteristics of Hypnic Headache Syndrome: 40 Patients Series from a Tertiary Referral Center. Headache. 2016 Apr;56(4):717-724. Tariq N, Estemalik E, Vij B, Kriegler JS, Tepper SJ, Stillman MJ.
Effect of OnabotulinumtoxinA Injection on Depression in Chronic Migraine. Headache. 2015 Oct;55(9):1218-1224. Maasumi K, Thompson NR, Kriegler JS, Tepper SJ.
Safety and Efficacy of Onabotulinumtoxin A for Chronic Migraines in the Elderly. a Comparison with PREEMPT-II Clinical Trial. Headache 55, 144-144. 2015. Tariq,N, E Estemalik, M Adil, SJ Tepper, J Kriegler.
Frequency of Migraine Headaches in Patients With Fibromyalgia. Headache. 2015 Jun;55(6):860-865. Vij B, Whipple MO, Tepper SJ, Mohabbat AB, Stillman M, Vincent A.
A comprehensive review of the use of deep brain stimulation (DBS) in treatment of psychiatric and headache disorders. Headache. 2015 Feb;55(2):345-350. Altinay M, Estemalik E, Malone DA Jr.
Triptan education and improving knowledge for optimal migraine treatment: an observational study. Headache. 2014 Apr;54(4):686-97. Baron EP, Markowitz SY, Lettich A, Hastriter E, Lovell B, Kalidas K, Dodick DW, Schwedt TJ; American Headache Society Headache Fellows Research Consortium
A Single Center, Randomized, Open-Label, Crossover Study Comparing a Sumatriptan/naproxen sodium Combination with Usual Triptan Monotherapy for Workplace Productivity Improvement in Migraine. 59th Annual American Headache Society Meeting, Boston, MA June 2017. Tarr,AM, Brena,J, Tepper,SJ, Kriegler,JS.
New treatments for headache. Neurol Sci. 2017 May;38(Suppl 1):145-156. Maasumi K Tepper SJ, Rapoport AM.
Patent Foramen Ovale and Migraine: Closing the Debate--A Review. Headache. 2016 Mar;56(3):462-78. Tariq N, Tepper SJ, Kriegler JS.
Nutraceutical and Other Modalities for the Treatment of Headache.Continuum (Minneap Minn). 2015 Aug;21(4 Headache):1018-31. Tepper SJ.
AVP-825 breath-powered intranasal delivery system containing 22 mg sumatriptan powder vs 100 mg oral sumatriptan in the acute treatment of migraines (The COMPASS study): a comparative randomized clinical trial across multiple attacks. Headache. 2015 May;55(5):621-35. Tepper SJ, Cady RK, Silberstein S, Messina J, Mahmoud RA, Djupesland PG, Shin P, Siffert J.
Cluster headache: potential options for medically refractory patients (when all else fails). Headache. 2013 Jul-Aug;53(7):1183-90. Tepper SJ, Stillman MJ.