I am a child neurologist with a subspecialization in headache medicine. I am the clinical director of the pediatric Headache Center at Cincinnati Children’s, and I also direct the Acute and Inpatient Headache Program at Cincinnati Children’s.
I spend most of my clinical time between the outpatient clinic — which is a multidisciplinary clinic with child neurologists, headache specialists, pain psychologists, researchers and nurse educators — and the inpatient service, where children and adolescents with intractable headaches are cared for by headache specialists to improve their symptoms and quality of life .
In addition, I collaborate in multiple clinical and pharmacological studies in our centers as an investigator or subinvestigator. The Headache Center at Cincinnati Children’s is the largest and most academically productive pediatric headache program in the U.S. and worldwide.
When I was a child, I was inspired to pursue medicine as a career after following stories about Doctors Without Borders. I was very interested in the work they did with children in underserved areas and how they make a difference for them.
I still have a picture in my mind of a child during the famine in Biafra. Though I was only 7 at the time, I felt the world was unfair to these children. There was so much more that could be done for them. I could not eat for days thinking of that unfairness. While my life has not yet taken me to those fields, it did give me many opportunities to take care of children and be proud of my accomplishments. I will one day be totally fulfilled when the final step of my dream becomes true.
In our practice, children are the priority. They are part of the team, and they are made aware of how important their input and opinions are from the minute they step into the clinic. Empowering them is our first goal when we are looking to succeed in improving their health.
Our outpatient clinics and our Acute and Inpatient Headache Program combine clinical evaluation and scientifically based therapies that use medications as well as behavioral education. We use an intense multidisciplinary approach that has been shown to be highly effective in treating pediatric headaches. The Headache Center also includes a large clinical research program that allows us to use state-of-the-art therapies for headaches and offers our patients all the available scientific data to improve their outcomes.
The main goal of the research I am involved in is to improve the clinical treatment of pediatric headaches, a disease that starts in childhood and can be carried through adulthood. If not well controlled in early stages, headaches can be devastating. They will not only inflict more severe pain but will also affect the quality of life of a child, which can include missing school and social opportunities.
I was honored to receive a Certificate of Excellence for my journal article “Use of Micro-strategy Tools and Financial Data: Evaluation of the economic impact of headache algorithms in pediatric populations with improvement of cost effectiveness when the algorithm is used appropriately.” I also received a Certificate of Excellence for another journal article, “Most Patients Impacted by Care Algorithm: Care algorithm to improve headache diagnosis in children and adolescents.”
I was the Pediatric and Adolescent Committee section chair for the American Headache Society from 2016 to 2018, and one of Cincinnati Magazine’s Top Doctors in 2013 and 2020. I am a fellow of the American Headache Society. I received an Allergan® Educational Award grant for “Understanding Neurotoxins” in 2005 and another Allergan® Educational Award grant for “Botulinum A Toxin as a Preventive Treatment of Chronic Migraine in Children and Adolescents.” I have published more than 100 manuscripts, abstracts and book chapters on pediatric migraine.
Gardening is very relaxing to me. For the last six years, I’ve been completing large planting projects on Mother’s Day weekend.
I love spending time with my family, and we enjoy traveling together and blending in with different cultures. I see it as an important educational experience that has helped us realize how similar we all are around the world — with a little charming twist that is special for each culture. We usually ask locals about recommendations or go with a local family to visit. These experiences also help me and my family to see the real treasures of a country. We discover not only hidden sceneries but genuine local life and excellent food — we are travel foodies!
MD: Saint Joseph University, Faculty of Medicine, Beirut, Lebanon.
Residency: Vanderbilt University Medical Center, Nashville, TN.
Fellowship: Cincinnati Children's Hospital, Cincinnati, OH.
Headaches; migraines; acute and inpatient treatment of intractable headache
Neurology, Headache Medicine
Headache; outcome studies; health improvement; clinical effectiveness
Neurology, Global Health
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The spectrum of indomethacin-responsive headaches in children and adolescents. Cephalalgia. 2022; 42:793-797.
Multimodal Assessment of Medication Adherence Among Youth With Migraine: An Ancillary Study of the CHAMP Trial. Journal of Pediatric Psychology. 2022; 47:376-387.
Nummular headache in children: A case series and systematic literature review. 2022; 5.
Predictors of Improvement in Pediatric Chronic Migraine: Results from the Cognitive-Behavioral Therapy and Amitriptyline Trial. Journal of Clinical Psychology in Medical Settings. 2022; 29:113-119.
Trajectory of treatment response in the child and adolescent migraine prevention (CHAMP) study: A randomized clinical trial. Cephalalgia. 2022; 42:44-52.
Standardized Headache Therapy in the Pediatric Emergency Department Using Improvement Methodology. Pediatric Quality and Safety. 2021; 6.
Prevalence of Headache Days and Disability 3 Years After Participation in the Childhood and Adolescent Migraine Prevention Medication Trial. JAMA Network Open. 2021; 4.
The promise of mechanistic approaches to understanding how youth with migraine get better-An Editorial to the 2020 Members' Choice Award Paper. Headache. 2021; 61:803-804.
The Development of the Medical Transfer Packet for Transition of Care of the Pediatric Patient with Headache. Headache. 2020; 60:2589-2591.
Clinic-based characterization of continuous headache in children and adolescents: Comparing youth with chronic migraine to those with new daily persistent headache. Cephalalgia. 2020; 40:1063-1069.
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