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Printable Handouts
Navigable Slide Index
- Introduction
- Disclosures - none relevant to this talk
- A thought experiment
- Theory and practice
- How to be a great doctor
- Questions in headache
- And more questions…
- Why are these questions important in patient care?
- Impact on disease management
- Pain and migraine
- What is pain?
- Is pain real?
- Evolutionary advantage of pain
- Pain is a relative condition
- Is migraine useful or harmful to the species and/or individual?
- What is migraine if not pain?
- How (and where) do we process pain?
- Pain response in rats
- Uniform response to migraine
- Treatment: adaptive
- Treatment: maladaptive
- Is migraine physiologic or pathologic?
- Migraine may provide a survival advantage
- Migraine in an evolutionary context
- Pain management
- The nature of the evolutionary role for migraine
- Physiologic or pathologic?
- Migraine as an untoward consequence
- Migraine as a cost/benefit trade-off
- Migraine as an adaptive response
- Migraine as an immune-mediated response
- Migraine as defence mechanism
- Friend or foe?
- How does this paradigm help?
- Challenges in acute management
- Problems with prevention
- Challenges with lifestyle modification
- And what about triggers?
- Triggers
- Conclusions
- Oh, and that thought experiment
- Others engaged in these diversions
- Acknowledgements
Topics Covered
- A philosophical perspective to migraine
- Impact of migraine pain management
- What is pain?
- An evolutionary advantage to pain
- Response to pain
- Adaptive and maladaptive treatment
- Is migraine physiologic or pathologic?
- Migraine triggers and prevention
Links
Series:
Categories:
Therapeutic Areas:
External Links
Talk Citation
Cowan, R.P. (2023, October 31). Headache and migraine: theory, practice, and challenges [Video file]. In The Biomedical & Life Sciences Collection, Henry Stewart Talks. Retrieved December 30, 2024, from https://doi.org/10.69645/RLKD8255.Export Citation (RIS)
Publication History
Financial Disclosures
- There are no commercial/financial matters to disclose.
Other Talks in the Series: Toward a Deeper Understanding of Headache and Migraine
Transcript
Please wait while the transcript is being prepared...
0:00
Hello.
Thank you for this opportunity
to speak about migraine.
This is a series of 16 or
so lectures about migraine.
It's a little different from
the usual textbook presentation.
We're going to do a
much deeper dive into
migraine and headache
from the perspective of
how best to understand
the phenomenon,
how to manage it,
and how to deal with
those unusual patients
that are outside the parameters
of the usual
treatment guidelines.
My name is Rob Cowan.
I'm a Higgins Professor of
Neurology and Neurosciences
at Stanford University
and the founding director of
the headache program there.
The title of my presentation is
Migraine from 30,000 feet.
0:46
I have no relevant disclosures,
but my other activities
are listed here.
0:52
We're going to begin by
thinking of this as a
thought experiment.
In this talk, I won't
be going through
diagnostic criteria
or treatment options,
rather we are going
to think about
migraine and head pain
from a philosophical
perspective.
I think it'll be very
instructive to frame
the challenges that we see
in clinical practice
with headaches.
1:15
There is a difference
between theory and practice.
A wonderful definition comes
from Bertrand Russell that
"Science is what you know.
Philosophy is what
you don't know."
Theory is everything
exclusive of
the technical precepts
and practical arts.
Other talks will go through
treatment strategies,
treatment options,
and things like that.
We're going to talk about
the philosophy of
migraine, to begin with.
I think there's a few
things that we all,