Browse Health
Neurologist (brain, nervous system)
29 years of experience
Accepting new patients

Education ?

Medical School
University Of The Witwatersrand (1981)
Foreign school

Awards & Distinctions ?

Awards  
Top 10 Doctor - Metro Area (2014)
San Diego County
Neurologist
Associations
American Board of Psychiatry and Neurology
American Headache Society

Affiliations ?

Dr. Blumenfeld is affiliated with 6 hospitals.

Hospital Affilations

Score

Rankings

  • UC San Diego Health System
    200 W Arbor Dr, San Diego, CA 92103
    • Currently 4 of 4 crosses
    Top 25%
  • Scripps Mercy Hospital San Diego
    4077 5th Ave, San Diego, CA 92103
    • Currently 4 of 4 crosses
    Top 25%
  • Tri-City Medical Center
    4002 Vista Way, Oceanside, CA 92056
    • Currently 3 of 4 crosses
    Top 50%
  • Scripps Memorial Hospital Encinitas
    354 Santa Fe Dr, Encinitas, CA 92024
    • Currently 3 of 4 crosses
    Top 50%
  • Scripps Memorial Hospital La Jolla
    9888 Genesee Ave, La Jolla, CA 92037
    • Currently 3 of 4 crosses
    Top 50%
  • SMH Encinitas
  • Publications & Research

    Dr. Blumenfeld has contributed to 10 publications.
    Title Botulinum Toxin Type A and Divalproex Sodium for Prophylactic Treatment of Episodic or Chronic Migraine.
    Date June 2008
    Journal Headache
    Excerpt

    OBJECTIVE: To compare the efficacy and safety of botulinum toxin type A (BoNTA; BOTOX: Allergan, Inc.) and divalproex sodium (DVPX; DEPAKOTE: Abbott Laboratories) as prophylaxis in reducing disability and impact associated with migraine. BACKGROUND: There is a need for effective, well-tolerated prophylactic treatment of migraine. DESIGN/METHODS: This was a randomized, double-blind, single-center prospective study. Fifty-nine patients received either BoNTA 100 U/placebo-DVPX bid or placebo-BoNTA/DVPX 250 mg bid. BoNTA/placebo injections were given at Day 0 and at Month 3. Patients were evaluated at Months 1, 3, 6, and 9. RESULTS: Both treatments showed significant improvements in migraine disability scores and reductions in headache days and headache index. A trend to decreased headache severity was observed with BoNTA. A greater percentage of DVPX patients reported adverse events possibly related to treatment (DVPX 75.8% vs BoNTA 50%, P = .04) and discontinued because of adverse events (DVPX 27.6% vs BoNTA 3.3%, P = .012). CONCLUSIONS: Both BoNTA and DVPX significantly reduced disability associated with migraine; BoNTA had a favorable tolerability profile compared with DVPX.

    Title An Integrated Management Program for Migraine: the Kaiser Experience.
    Date November 2004
    Journal Managed Care Interface
    Title Botulinum Neurotoxin for the Treatment of Migraine and Other Primary Headache Disorders.
    Date August 2004
    Journal Dermatologic Clinics
    Excerpt

    Clinical data and experience to date have demonstrated that BoNT-A is an effective and well-tolerated therapy for the prevention of migraine and other headache disorders. It has a long duration of action that may last over 4 months with no systemic or serious AEs. Several issues remain to be defined, however, including dosing, location, and number of injections; optimal dilution of BoNT-A; specific headache types that respond best to BoNT-A; and long-term efficacy and safety. Data from ongoing well-designed trials that include a larger patient population investigating these issues may confirm a role for BoNT-A as a first-line agent for migraine prevention. Neurotoxin therapy is part of a broader headache management approach. Because the injection techniques for headache are unique and vary depending on the primary headache disorder being treated and the location and pattern of pain referral, the use of BoNT-A for headache is not simply an extension of its use for cosmesis. The use of BoNT-A in the overall management of primary headache disorders should be reserved for medical practitioners who not only have experience with BoNT-A injections, but possess the expertise in the diagnosis and management of complex headache disorders. Educating patients and addressing headache triggers and optimizing acute treatment improve the outcome of any preventive program.

    Title Procedures for Administering Botulinum Toxin Type A for Migraine and Tension-type Headache.
    Date February 2004
    Journal Headache
    Title Efficacy and Safety of Modafinil (provigil) for the Treatment of Fatigue in Multiple Sclerosis: a Two Centre Phase 2 Study.
    Date February 2002
    Journal Journal of Neurology, Neurosurgery, and Psychiatry
    Excerpt

    OBJECTIVE: To assess the efficacy and safety of modafinil for the treatment of fatigue in multiple sclerosis (MS). METHODS: Patients aged 18-65 years with a diagnosis of MS, a stable disability level < or =6 on the Kurtzke extended disability status scale (EDSS), and a mean score >4 on the fatigue severity scale (FSS) were eligible for the 9 week, single blind, phase 2, two centre study. Exclusion criteria included a diagnosis of narcolepsy, sleep apnoea, or clinically significant major systemic disease and recent use of medications affecting fatigue. All patients, who remained blinded for the treatment regimen, received placebo during weeks 1-2, 200 mg/day modafinil during weeks 3-4, 400 mg/day modafinil during weeks 5-6, and placebo during weeks 7-9. Safety was evaluated by unblinded investigators. Efficacy was evaluated by self rating scales, using the FSS, the modified fatigue impact scale (MFIS), a visual analogue scale for fatigue (VAS-F), and the Epworth sleepiness scale (ESS). Adverse events were recorded. RESULTS: Seventy two patients (MS type: 74% relapsing-remitting; 7% primary progressive; 19% secondary progressive) received treatment. After treatment with 200 mg/day modafinil for 2 weeks, a significant improvement in fatigue versus placebo run in was demonstrated. Mean scores after treatment with 200 mg/day modafinil were: FSS, 4.7 versus 5.5 for placebo (p<0.001); MFIS, 37.7 versus 44.7 (p<0.001); and VAS-F, 5.4 versus 4.5 (p=0.003). Fatigue scores for 400 mg/day modafinil were not significantly improved versus placebo run in. Mean ESS scores were significantly improved (p<0.001) with 200 mg/day modafinil (7.2) and 400 mg/day (7.0) versus the score at baseline (9.5). Serious adverse events were not found at either dose. The most common adverse events were headache, nausea, and aesthenia. Sixty five patients (90%) completed the study. CONCLUSIONS: These data suggest that 200 mg/day modafinil significantly improves fatigue and is well tolerated in patients with MS.

    Title Coexistence of Lambert-eaton Myasthenic Syndrome and Subacute Cerebellar Degeneration: Differential Effects of Treatment.
    Date November 1991
    Journal Neurology
    Excerpt

    A 61-year-old woman presented with two paraneoplastic neurologic disorders--Lambert-Eaton myasthenic syndrome (LEMS) and subacute cerebellar degeneration (SCD)--that antedated the diagnosis of small-cell carcinoma of the lung by 15 months. Plasmapheresis initiated before the identification of the tumor had a beneficial effect on LEMS but did not affect the SCD. Chemotherapy administered for treatment of the primary tumor was also associated with improvement of LEMS but, like plasmapheresis, had no effect on SCD. While the pathogenesis of both LEMS and SCD is thought to be mediated predominantly by humoral immune factors, a differential therapeutic response indicates that mechanisms of tissue damage or susceptibility to tissue injury, or both, differ in these two disorders.

    Title The Importance of Carotid Artery Plaque Disruption and Hemorrhage.
    Date October 1987
    Journal Archives of Neurology
    Excerpt

    The event or mechanism that causes an asymptomatic atherosclerotic carotid artery to become symptomatic remains uncertain. Analysis of carotid endarterectomy surgical specimens from symptomatic patients has suggested that primary intraplaque hemorrhage is the most important initiating event. Reanalysis of several recent series of carotid endarterectomy specimens demonstrated that plaque disruption (ulceration) occurs as frequently as plaque hemorrhage, and that both processes are significantly more frequent in symptomatic as compared with asymptomatic endarterectomy specimens. A review of the coronary artery pathology literature reveals that plaque disruption is commonly present in patients with acute fatal myocardial infarction. It is widely asserted that coronary artery plaque disruption leads to luminal thrombosis and intraplaque hemorrhage. A similar sequence of events may occur in symptomatic carotid arteries.

    Title Acute Autonomic Neuropathy with Salmonella Typhi Infection. A Case Report.
    Date May 1987
    Journal South African Medical Journal = Suid-afrikaanse Tydskrif Vir Geneeskunde
    Excerpt

    Acute autonomic neuropathy is a well-described clinical entity that is easy to diagnose with appropriate bedside tests. This condition is described in a patient who had a concurrent Salmonella typhi infection. The relationship between the two conditions is not entirely clear, but the simultaneous disappearance of the S. typhi from stool, the drop in Widal titres and rather early recovery of the autonomic neuropathy tend to implicate S. typhi as the causative agent.

    Title Probable Chloroquine-resistant Plasmodium Falciparum Malaria in South-western Africa.
    Date September 1984
    Journal South African Medical Journal = Suid-afrikaanse Tydskrif Vir Geneeskunde
    Excerpt

    Chloroquine-resistant Plasmodium falciparum malaria has been described in East, Central and West Africa. We report on 2 patients with probable chloroquine-resistant P. falciparum malaria in south-western Africa. Both patients had been in northern SWA/Namibia and southern Angola, but had taken prophylactic chloroquine. Despite the subsequent administration of adequate courses of chloroquine therapy, the parasitaemias failed to clear completely. Eventual clinical and laboratory-proven cure was only obtained in 1 case after combined quinine and tetracycline therapy. To our knowledge, these represent the first cases of probable chloroquine-resistant P. falciparum malaria acquired in this area.

    Title A Multi-center Double-blind Pilot Comparison of Onabotulinumtoxina and Topiramate for the Prophylactic Treatment of Chronic Migraine.
    Date
    Journal Headache
    Excerpt

    This multi-center pilot study compared the efficacy of onabotulinumtoxinA with topiramate (a Food and Drug Administration approved and widely accepted treatment for prevention of migraine) in individuals with chronic migraine (CM).

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