Wednesday, August 31, 2011

Poor Sleep Quality Increases Risk of High Blood Pressure

Reduced slow wave sleep (SWS) is a powerful predictor for developing high blood pressure in older men, according to new research in Hypertension: Journal of the American Heart Association.

SWS, one of the deeper stages of sleep, is characterized by non-rapid eye movement (non-REM) from which it's difficult to awaken. It's represented by relatively slow, synchronized brain waves called delta activity on an electroencephalogram. Researchers from the Outcomes of Sleep Disorders in Older Men Study (MrOs Sleep Study) found that people with the lowest level of SWS had an 80 percent increased risk of developing high blood pressure.

"Our study shows for the first time that poor quality sleep, reflected by reduced slow wave sleep, puts individuals at significantly increased risk of developing high blood pressure, and that this effect appears to be independent of the influence of breathing pauses during sleep," said Susan Redline, M.D., the study's co-author and Peter C. Farrell Professor of Sleep Medicine in the Department of Medicine at Brigham and Women's Hospital and Beth Israel Deaconess Medical Center, Harvard Medical School in Boston, Mass.

Men who spent less than 4 percent of their sleep time in SWS were significantly more likely to develop high blood pressure during the 3.4 years of the study. Men with reduced SWS had generally poorer sleep quality as measured by shorter sleep duration and more awakenings at night and had more severe sleep apnea than men with higher levels of SWS. However, of all measures of sleep quality, decreased SWS was the most strongly associated with the development of high blood pressure. This relationship was observed even after considering other aspects of sleep quality.

Insomnia cures via Android and iOS apps

Unfortunately there are times when most of us will suffer some from of insomnia at one time or another. So today we are looking at insomnia cures via Android and iOS apps to help you get that good nights sleep.

First up we have Natural Cures for Insomnia 1.0 which is available for owners of the iPhone, iPad, and iPod Touch. The application has been designed to help users to beat insomnia without resorting to drugs or other methods. It teaches you how to prepare your body for relaxation, set the right mood for a comfortable sleep atmosphere, use music and other relaxation techniques, and much more.

It also shows users how to use herbal teas and warm drinks which can help relaxation, and what herbs and vitamins that can promote natural sleep. There are even recipes for herbal teas and instructions on how to make your own herbal satchels. The application is stored directly to the device so no internet connection is needed.

Find the feature packed Natural Cures for Insomnia 1.0 on the App Store for only $0.99/£0.69. iOS 3.0 or later required. The Natural Cures For Insomnia is an application for users of Android devices.

Overcoming Insomnia – Learn to Sleep Like a Baby 1.0 is another application for owners of iDevices and is currently on offer on the App Store. The application is packed with all the information you need with chapters that include the sleep cycle, diagnosing insomnia, medications that can help, natural cures for insomnia, and much more.

The application is ideal for those people who don’t want to resort to sleeping pills but still get a good night’s sleep. Overcoming Insomnia – Learn to Sleep Like a Baby 1.0 is available worldwide on theApp Store for the discounted price of $0.99/£0.69. iOS 2.0 or later required.

Insomnia or Sleep Disorder is another application which is available for users of the Android platform, and is also currently on offer. The application will teach users the difference between insomnia and sleeping disorders, how depression relates to insomnia, details of how insomnia can affect your health, whether over the counter remedies work, and much more.

Read more at:

Localizing Language in the Brain: Study Pinpoints Areas of the Brain Used Exclusively for Language

New research from MIT suggests that there are parts of our brain dedicated to language and only language, a finding that marks a major advance in the search for brain regions specialized for sophisticated mental functions.

Functional specificity, as it's known to cognitive scientists, refers to the idea that discrete parts of the brain handle distinct tasks. Scientists have long known that functional specificity exists in certain domains: In the motor system, for example, there is one patch of neurons that controls the fingers of your left hand, and another that controls your tongue. But what about more complex functions such as recognizing faces, using language or doing math? Are there special brain regions for those activities, or do they use general-purpose areas that serve whatever task is at hand?

Language, a cognitive skill that is both unique to humans and universal to all human cultures, "seems like one of the first places one would look" for this kind of specificity, says Evelina Fedorenko, a research scientist in MIT's Department of Brain and Cognitive Sciences and first author of the new study. But data from neuroimaging -- especially functional magnetic resonance imaging (fMRI), which measures brain activity associated with cognitive tasks -- has been frustratingly inconclusive. Though studies have largely converged on several areas important for language, it's been hard to say whether those areas are exclusive to language. Many experiments have found that non-language tasks seemingly activate the same areas: Arithmetic, working memory and music are some of the most common culprits.

But according to Fedorenko and her co-authors -- Nancy Kanwisher, the Walter A. Rosenblith Professor of Cognitive Neuroscience, and undergraduate student Michael Behr -- this apparent overlap may simply be due to flaws in methodology, i.e., how fMRI data is traditionally gathered and analyzed. In their new study, published in this week's Proceedings of the National Academy of Sciences, they used an innovative technique they've been developing over the past few years; the new method yielded evidence that there are, in fact, bits of the brain that do language and nothing else.

Read more at:

Sleep artist creates masterpieces whilst not awake

An artist from North Wales who paints only when he is asleep now seems to have a global demand for his work.

Lee Hadwin, 36, from Denbigh has no artistic training, no natural sketching talent (during the day) and no inclination in waking life to be an artist.

Despite this he manages to draw and sketch portraits, figures and landscapes whilst asleep, with some of his masterpieces reportedly selling for up to six-figure sums.

According to Lee's Facebook page, he started drawing in his sleep when he was four but it was not until he was 15 that his nocturnal talent as an artist began to emerge.

During his late teens he would draw or scribble on walls, tables, clothes, discarded newspapers, but he now prepares before bedtime by leaving sketch books and materials scattered around his flat.

Lee claims he cannot draw when he is awake and he has never been to art college or studied the subject.

Read more at:

Monday, August 29, 2011

Radical brain surgery frees baby held captive by seizures

Evan Stauff smiles and giggles. He mimics his father in making silly noises. He loves to play with toys and watch cartoons.

The 19-month-old didn’t do any of those things before undergoing surgery this past winter to remove half of his brain, a procedure that’s called a “hemispherectomy.” His family noticed a change in his behavior almost immediately — starting with his ability to focus on family members, rather than look through them.

“It’s already a miracle,” said Evan’s grandmother, Karen Sands of Payette. “He’s a person now; he wasn’t before.”

Evan was diagnosed with infantile spasms when he was almost 3 months old. The spasms were the result of a specific kind of epilepsy that develops in young children.

They came in clusters, and his episodes lasted five to 15 minutes. Evan’s dad, 31-year-old David Stauff, believes he witnessed his baby go through thousands of spasms over a seven-month period before the surgery.

“His brain was always in a state of seizure,” said Kathleen Stauff, Evan’s mom. The baby was physically exhausted by the seizures and had a very erratic sleep pattern.

He was lethargic and catatonic — “trapped inside,” Sands said.

Before the surgery, Evan wasn’t able to sit up — or even able to hold his head up — and he couldn’t grab and hold toys. Now he’s able to sit and play on the floor of his grandparents’ Eagle home.

He’s still behind developmentally but is progressing.

“He’s doing really well. We couldn’t be any happier,” said his father, who quit his job at a credit union to care for the youngest of his three boys.

Read more:

What is wrong with the picture? "In 2011, concussion awareness not a formality"

I added this article because the pciture shows the problem with pre-season psychological testing. The instructions clearly state that you have to doe this test free of distraction. If distracted, the results of test will be worse and the test will be less sensitive at detecting change from baseline.

I continue to advocate that EVERY school's testing protocol should be overseen by subject matter experts. JR

Long gone are the days of completing a physical form, signing a permission slip and hitting the playing field.

Now, before any student-athlete straps on his helmet and pads, laces her soccer cleats or stretches for cheerleading — or even prepares to high-step it with the band — he or she must have completed a concussion awareness program mandated by the state and MIAA.

Although a state law was enacted last fall, it left schools little time to follow through with the requirement that all student-athletes and band participants and their parents view a concussion education video online and complete and sign paperwork detailing an athlete’s concussion history.

In addition, all coaches, athletic directors, trainers and officials must complete online training regarding concussions.

Read more at:

Poor Sleep May Raise Blood Pressure

Not getting enough deep sleep may raise your blood pressure.
A new study shows men who got the least deep sleep were 80% more likely to develop high blood pressure than those who got the most.
Researchers determined how much deep sleep the men got by measuring the speed of their brain waves. People with poor-quality sleep spend a lot of time in "slow wave" sleep.
It's the first study to show that poor sleep quality independently raises the risk of high blood pressure, regardless of sleep duration or other sleep issues.

Read more at: this site.

Sleep hygiene and the new school year

Make sure your child gets enough sleep

KENNEWICK, Wash.- Experts say if your child starts bringing home bad grades this school year, you might want to take them in for a sleep study.

Analysts at KGH's Columbia Sleep Center say many of their patients are children. They say young kids need at least ten hours of sleep a night; any less could lead to bad health and bad grades.

"Almost always are having difficulties with their school work. Either because they're falling asleep in class or unable to focus or pay attention in class," says Polysomnographic Technician Jay Miller.

Miller says you should have your child practice good sleep hygiene. Set up a consistent bed time, turn off the TV, and don't have dinner any later than three hours before it's time to go to sleep.

Read more at:

The Curious Link Between H1N1 Flu and Narcolepsy

A swell in new cases of narcolepsy in China followed seasonal patterns of flu, including H1N1, according to a recent study led by Dr. Emmanuel Mignot of the Stanford University School of Medicine. The new cases appear to be associated with flu infection itself, not with flu vaccinations.

A peak in cases of narcolepsy — an autoimmune disease that causes people to fall asleep suddenly — occurred about five to seven months after a peak in cold and flu cases in the country, the study found. Onset in the spring was seven times more common than in the winter.

Researchers believe that people have a genetic predisposition to narcolepsy, which may be triggered by some environmental factor, such as an upper airway infection. Reported the New York Times:

Narcolepsy and a related but even rarer illness, cataplexy — a tendency to collapse when swept by strong emotions — are caused by the death of brain cells that secrete hypocretin, which regulates sleep. Those cells, Dr. Mignot explained, are probably killed by autoimmune reactions that stem from winter infections like flu and strep throat.

For several years after the 1918 Spanish flu pandemic, medical authorities described a seasonal somnolence they called "encephalitis lethargica."

Read more:

Sunday, August 28, 2011

BIG NEWS - How do you feel about changes to Texas ECI eligibility?

BIG NEWS - How do you feel about changes to Texas ECI eligibility?

Please note the bolded areas. While I agree with the arithmetic, a two year old will need to have a DQ of 18 months to qualify. To me this stresses the need for a medical diagnosis under the first criterion. JR

Message from Commissioner Debra Wanser About Changes in ECI Eligibility

I would like to thank the parents, physicians, advocates and providers who submitted written comments on our rules. Your concern for children with developmental delays and your support for ECI are very evident and much appreciated.

You may know that the DARS funding appropriation for Early Childhood Intervention (ECI) services for fiscal years 2012 and 2013 was about 14 percent less than funding levels for the program in 2011. As a result, DARS will narrow eligibility criteria for the ECI program.

The positive news is that we will not have to narrow as much as we originally thought when we first proposed rules in May 2011. We believe that we will continue to be able to serve those children and families most in need of our services. We are funded to serve, on average, almost 28,000 children and their families per month.

Effective September 1, 2011, a child will be eligible for ECI services if he or she:

  • Has a medically diagnosed condition that has a high probability of resulting in developmental delay. This has not changed.

  • Has an auditory or visual impairment as determined by school district personnel using Texas Education Agency criteria. This has not changed.

  • Has a delay of at least 25% in one or more areas of development (motor, communication, cognition, social-emotional or self-help). For example, a child who is 16 months of age would have to have a delay of four months or more to be eligible. This is slightly more delay than would have been required in the past (in this example, three months).

The new eligibility criteria will apply to children who enroll in the program on September 1, 2011 or after. Families currently enrolled will continue to receive services and have their eligibility re-determined at least annually, as required by federal regulations. Children’s continuing eligibility is based on having a medically diagnosed condition, auditory/visual impairment or evidence of a developmental delay.

DARS ECI will continue to identify and use all available funding sources while adhering to federal and state regulations. In addition, we have implemented several changes to both maintain and enhance the quality of our services. Our goal is to safeguard ECI's long term viability while ensuring alignment with the strengths and priorities of the program. Thank you again for your continued support and interest.


Debra Wanser

Saturday, August 27, 2011

Study: Women Sleep More Than Men; Complain Of Exhaustion More

Unless you’re stuck in your teenage years where 12 hours of sleep was the norm, chances are you’re tired. Whether your boss doesn’t seem to acknowledge that the rest of the world has a life after 5pm, your two-year-old (or 12-year-old) refuses to go to bed, or you just can’t make yourself turn off Conan, the next day can be exhausting and draining. And while a sleep-deprived state is not fun for anyone, researchers found women actually get more shut-eye than men–we justcomplain more about being tired.

Studies have shown that women typically sleep deeper than men and wake up fewer times during the night. We even tend to perform better in a sleep-deprived state, so one would assume that we would be happier about our sleep, but it’s guys who say they are more satisfied with the quality and quantity of sleep.

Read more at:

Study of Football Head Collisions - Sensors in Helmet

Practice for the U of R football team is underway this week. Ten players will be wearing specially designed helmets that could ultimately help to reduce dementia in NFL players down the road.

There's been growing attention focused on the impact of concussions in the NFL. Now U of R Medical Center concussion specialist Dr. Jeffrey Bazarian wants to know the cumulative impact to all these hits.

Dr. Bazarian says, "What we're trying to see is the amount of force over the season these with special brain scans in the beginning of the season and repeat it at the end of the season."

To do that, 10 members of the of of the U of R Yellowjackets are wearing helmets with built in sensors. Players like captain John Whiting got a baseline brain scan before the season began.

Whiting says, "They did an MRI took some blood, at the end of the season we'll do the same thing and at the end we'll see the impact to the head and what it has throughout the season."

Players turn in their helmets after each practice and game and the information is recorded. Whiting had 64 hits today.

Read more at:

Bratty Child? Is He Getting Good Sleep?

It isn’t news that children who are tired are just plain ugly to be around. The bad attitudes, the negative response and lack of engagement are signals to any caretaker that the child under their care needs a nap, or to simply to go to bed for the evening.

Sadly, we are now seeing a larger and larger percentage of children with sleep disorders. A team of eight researchers from Ann Arbor, Michigan investigated whether urban school children with aggressive behaviors were more likely than their peers to display symptoms of sleep disordered breathing. If this is true, this type of breathing effectively inhibits oxygen flow to the brain, creating behaviors very similar to an overly-tired toddler.

The results of the study indicate that aggressive children (e.g. with conduct problems, bullying, or discipline referrals), in comparison to their non-aggressive peers more often had symptoms suggestive of sleep-disordered breathing. Children with conduct problems were more likely to snore habitually. However, sleepiness, and not snoring, predicted the conduct issues.

Read more:

The 'Secret' Perks Of Being A Middle Child

Stereotypes about middle children are hardly flattering. They're often described as confused underachievers, overshadowed by older and younger siblings, and overlooked by their parents.

But in The Secret Power of Middle ChildrenCatherine Salmon and Katrin Schumann argue that many middle-borns have hidden strengths and are agents of change in business, politics and science.

Salmon and Schumann join NPR's Rebecca Roberts to discuss the perks of being a middle child.

Wednesday, August 24, 2011

New!! Epilepsy Warriors - "Ask a Doc"

Ask a Neurologist on FaceBook - Epilepsy Warriors

Welcome to a new weekly feature of the epilepsy warriors Facebook page.

Every week, a question will be selected. Volunteer neurologists will answer the question. We will protect personal information and answer questions in a general way that educates the group.

Any question related to epilepsy is fair game. There is something to learn from everyone so don’t be afraid to ask a question no matter how strange it may seem.

Please follow this link to my blog to submit questions.

To date, our volunteer team of board-certified neurologists includes:

Dr. Mark DiFazio, Rockville Maryland
Dr. Kevin Joseph, Seattle Washington
Dr. Joshua Rotenberg, Houston Texas

Tuesday, August 23, 2011

New Concussion Law - Rotenberg in the Lone Star Texas News

Posted: Tuesday, 02 August 2011 11:55AM

New Concussion Law

As high school football practice gets underway--a new rule is in place designed to protect teenagers against concussions.Under the law that took effect Monday, coaches are required to take players out after a head hit to check for a concussion. San Antonio neurologist Joshua Rotenberg says that's because concussions aren't obvious and players don't want to admit they're hurt. He adds that sometimes players think they feel okay only to have the effects of a concussion be obvious minutes or even hours later.

Monday, August 22, 2011

New device could help combat on-ice concussions

Sport-related concussions are becoming a growing concern among athletes, but one Ottawa company thinks it might have part of the solution: a piece of electronics that can measure the impact of on-ice hits to the head.

The device, which is a few inches long and about an inch thick, was developed by Impakt Protective Inc. Danny Crossman, the company's CEO, described it as "a small sensor" that's programmed to communicate via a Bluetooth technology to a smartphone like a BlackBerry.

The sensor sends data to the phone, which indicates the direction and magnitude of the hit, he said.

Although the device won't head off a concussive hit, the idea is that it can register when a player has suffered a concussion so that coaches or trainers can begin treatment right away.

"If a player's flat-out on the ice it's pretty easy to figure out something's happened," Crossman said.

But doctors are becoming increasingly concerned with "low-threshold hits," which he said might have a cumulative impact on a player. The device his company has developed could help "recognize" those, he said.

The sensor is small enough that it can embedded in a hockey or football helmet "amongst the padding," Crossman said. Impakt Protective is also looking at ways to install the device in older helmets, not just new ones.

Read more at:

Researchers identify possible trigger point of epileptic seizures

Researchers at the Stanford University School of Medicine have identified a brain-circuit defect that triggers absence seizures, the most common form of childhood epilepsy.

In a study published online Aug. 21 in Nature Neuroscience, the investigators showed for the first time how defective signaling between two key brain areas — the cerebral cortex and the thalamus — can produce, in experimental mice, both the intermittent, brief loss of consciousness and the roughly three-times-per-second brain oscillations that characterize absence seizures in children. Young patients may spontaneously experience these seizures up to hundreds of times per day, under quite ordinary circumstances.

The new findings may lead to a better understanding of how ordinary, waking, sensory experiences can ignite seizures, said John Huguenard, PhD, the study’s senior author.

Read more at:

Tips for sleepy teens

Some parents resort to screaming. Others bang on doors or yank off covers. When it is time to wake up teens for school, things can get ugly.

The root causes of this battle are not mysterious. Teen bodies need about nine hours of sleep and are biologically primed to fall asleep around 11 p.m. But school schedules require many to get up before dawn.

The result: Typical teens are chronically sleep-deprived, Emsellem says. Many are in their deepest phase of sleep just about the time parents start nagging them to wake up, she says.

"This is not just obstinate behaviour," she says. "This is biology."

Now is the perfect time to talk with your teen about solutions. "Tell them that you don't want to go through this routine again this year," Emsellem says. Here are some things to try:

- Shift responsibility. Emsellem suggests asking your teen: "How can I help you take responsibility for this?" They need to learn to wake up without you sooner or later. If they still need help, limit it: For example, Emsellem says a parent might offer to check once to see if the teen is awake. "If you walk in their room four times every morning, they know you will keep doing that."

- Educate them. Ask them to keep a log of their sleep patterns for a couple of weeks. Just seeing how little sleep they get may help them make changes, such as finishing homework and getting to bed earlier.

- Watch out for weekends. Typical teens compound their problems by staying up and getting up much later on weekends, pushing their body clocks off school-week schedules. Kohler tells teens to get up "no more than an hour or two later" than on weekdays. Emsellem says 8 a.m. may seem brutal, but "anything after 10 a.m. is out of bounds."

- Enlighten them. Tell teens that light from computer and TV screens just before bedtime will keep them awake. Light in the morning will help them wake up. Kohler suggests some teens get a light therapy box that simulates sunlight and comes on with their alarm.

When those measures fail? Emsellem says it may help to say you won't give them a ride or write an excuse if they wake up late.

Read more:

Saturday, August 20, 2011

AccessSurf - Surfing for People with Disabilities

AccessSurf Hawaii

I just had patients return from Hawaii where they took their son
surfing with accessSurf.

They had a great experience.
Check with your physician if this is appropriate for you or your child.



Our Mission:

AccesSurf empowers people with disabilities by providing adaptive surfing instruction and therapeutic educational programs on water recreation and enriches lives by assisting families to access the beach and ocean in a barrier free environment.
Our Vision:
In the aloha spirit that Duke Kahanamoku, “The Father of Surfing,” introduced surfing to others, AccesSurf will be the leader in recreation and leisure opportunities in the beach environment for people with disabilities through providing therapeutic instruction for the advancement of adaptive surfing and ocean recreation throughout the state of Hawaii and worldwide for generations to come.

Friday, August 19, 2011

Back-To-School Sleeping Tips on Texas Public Radio

They'll put any Houston pediatric neurologist the radio on a slow news day.
Back-To-School Sleeping Tips on Texas Public Radio
With the first day of school right around the corner, parents are trying to get their kids back on a school-year sleeping schedule. Texas Public Radio’s Eileen Pace reports it’s not too late to get some use out of the tips from a local sleep expert.

August 18, 2011 · Dr. Josh Rotenberg says kids sleep when they get sleepy during the summer — sometimes 11:00 or midnight — and then sleep late the next morning.
“When kids have social constraints removed from them, they live naturally. They’re like free-range chickens,” Rotenberg says.
In fact, he says those studies showing kids have a later wake-up clock than adults do are true.
“What’s really interesting is that I see over the summer many fewer kids for headaches and ticks because I think kids are allowed to sleep longer over the summer. And there are a number of studies that show that a delayed school start time — so when you move a school start time in high school from 7:30 to 9:00 — grades go up,” Rotenberg says.
Schools generally have not pushed back their start times.

Thursday, August 18, 2011

Knocked Out - Great Journalism on Concussion

Across the country, people have awakened to the sometimes irreversible damage of concussions, especially in high-impact professional sports. With much of the attention focused on the National Football and National Hockey leagues, the Houston Press — following a months-long, nationwide investigation into the consequences of concussion on youth athletes, who are bigger and more aggressive than in past generations, and often play year-round — has found the following:

• The effect of a concussion on kids can be much more devastating than on adults. Doctors say that until a person is in his early to mid-20s, his brain is not fully developed and can't take the same level of trauma as an adult brain can.

• Postmortem analysis, the only surefire way to measure concussions' devastating effects, shows that repeated blows to the head may be linked with Alzheimer's, Parkinson's, ALS and a number of other fatal diseases.

• An athlete who doesn't exhibit outward signs of a concussion (headaches, dizziness, vomiting, temporary amnesia) can still experience changes in brain activity similar to those in a player who has been clinically diagnosed with a concussion.

• The ImPACT test, widely regarded as the go-to neurological exam to measure concussive blows, doesn't always accurately gauge a player's readiness to return to action. And you can cheat on it.

Read more at:

School Migraines - Tips for Back to School

Migraines in Kids Many people think migraines are an adult problem. However, the condition can occur in children, too. The Migraine Research Foundation estimates up to 10 percent of children in the U.S. have migraines. Half of them have their first attack of symptoms before 12.

Migraines have even been reported in children as young as 18 months. At younger ages, migraines are more common in boys. However, by adolescence, incidence becomes more common in girls. For many females, migraines are commonly triggered by hormone changes associated with the menstrual cycle.

Diagnosis of migraines in children can be tricky. Children typically don’t have the same type of symptoms as adults. The head pain may be two-sided and not as severe as an adult migraine. Children are more likely to experience nausea, vomiting abdominal pain or dizziness in association with a migraine.

Dealing with Childhood Migraines The Migraine Research Foundation estimates children who have migraines miss an average of 7.8 days from school each year (compared to 3.7 for the average child without migraines). Noah Rosen, M.D., Neurologist/Psychiatrist with The Headache Center in Manhasset, NY says teachers, administrators and other students often don’t understand the significance of migraine symptoms. However, as with adults, migraines in children can be debilitating. When symptoms last more than a day, or are frequent, it can be very difficult for a child to keep up with schoolwork.

Currently, there are no migraine medications specifically approved for children. So doctors may need to carefully explore drug options, weighing risks of potential side effects against benefits of pain relief or prevention. Families can also take steps to reduce the risk for migraines:

Eat regular meals/do not skip a meal.

Drink plenty of fluids.

Keep a regular sleep schedule.

Exercise daily.

Rosen is also creating a migraine awareness campaign for students and school nurses. The goal is to have materials available for download that can be used to educate teachers, administrators and students about the prevalence and severity of migraine in school children.

For general information on migraines in children:
American Headache Society,
American Migraine Foundation,
Migraine Research Foundation,
National Headache Foundation,
National Institute of Neurological Disorders and Stroke,

Read more at: