Browse Health
Neurology
31 years of experience
Video profile
Accepting new patients

Education ?

Medical School Score Rankings
University of Minnesota at Duluth (1979)
  • Currently 3 of 4 apples
Top 50%

Awards & Distinctions ?

Awards  
Patients' Choice Award (2008)
Associations
American Headache Society
Member

Affiliations ?

Dr. Frishberg is affiliated with 4 hospitals.

Hospital Affilations

Score

Rankings

  • Palomar Medical Center *
    555 E Valley Pkwy, Escondido, CA 92025
    • 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%
  • UC San Diego Health System
  • * This information was reported to Vitals by the doctor or doctor's office.

    Publications & Research

    Dr. Frishberg has contributed to 6 publications.
    Title Twelve-month Tolerability and Safety of Sumatriptan-naproxen Sodium for the Treatment of Acute Migraine.
    Date March 2007
    Journal Mayo Clinic Proceedings. Mayo Clinic
    Excerpt

    OBJECTIVES: To evaluate the long-term safety and tolerability of sumatriptan-naproxen sodium for the treatment of moderate to severe acute migraines and to assess the safety of administration of an optional second dose. PATIENTS AND METHODS: A 12-month, multicenter, open-label safety study was conducted in adults treated for migraine attacks of moderate to severe intensity from April 14, 2004, to August 18, 2005. Safety evaluations included adverse events and laboratory tests. RESULTS: Of 600 patients enrolled, 565 (94%) were treated for at least 1 migraine. Of treated patients, 414 (73%) and 362 (64%) completed 6 and 12 months of treatment, respectively. Of the 24,485 attacks treated, 17,144 (70%) were treated with only 1 dose. On average, patients treated 5 migraine attacks per month, with a median of 6 days between attacks. The most common treatment-related adverse events were nausea, muscle tightness, and dizziness. Fourteen patients reported 1 or more serious adverse event with only 1 judged probably related to treatment. No deaths occurred. Eight percent of patients discontinued participation in the study because of adverse events or pregnancy. The rates of adverse events reported were no higher after treatment with 2 tablets (at least 2 hours apart) compared with 1 tablet. CONCLUSIONS: In this 12-month data set of more than 24,000 migraine attacks in 565 patients, sumatriptan-naproxen sodium formulated in a single tablet was well tolerated when used episodically for the treatment of acute migraine. The adverse events did not differ from those expected for the individual components alone, and no new or unexpected findings occurred.

    Title Botulinum Toxin Type A (botox) for the Prophylactic Treatment of Chronic Daily Headache: a Randomized, Double-blind, Placebo-controlled Trial.
    Date August 2005
    Journal Headache
    Excerpt

    OBJECTIVE: The objective of this study was to evaluate the safety and efficacy of botulinum toxin type A (BoNT-A; BOTOX, Allergan, Inc.) for the prophylactic treatment of chronic daily headache (CDH). BACKGROUND: Several open-label and small controlled trials suggest that BoNT-A may be effective in the prophylactic treatment of headache. DESIGN AND METHODS: This was an 11-month, randomized double-blind, placebo-controlled study of BoNT-A for the treatment of patients aged 18 to 65 years old with 16 or more headache days per 30 days conducted at 13 North American study centers. Following a 30-day screening period and a 30-day, single-blind, placebo-response period to identify placebo responders, eligible patients from both the placebo responder and placebo nonresponder groups were injected with BoNT-A or placebo every 90 days and assessed every 30 days for 9 months, a period encompassing three treatment cycles. The primary efficacy measure was the change from baseline in the frequency of headache-free days in a 30-day period for the placebo nonresponder group at day 180, the chosen efficacy time point. The secondary efficacy measure was the proportion of patients with a decrease from baseline of 50% or more in the frequency of headache days per 30-day period for the placebo nonresponder group at day 180. The change from baseline in the frequency of headaches (per 30-day period), the proportion of patients with a decrease from baseline of 50% or greater in the frequency of headaches per 30-day period, acute medication use, and adverse events were also assessed. RESULTS: Of 571 patients assessed over the baseline period, 355 (mean age, 43.5 years; 300/355 [84.5%] female) were enrolled and randomized. At the end of the placebo run-in period, 279 patients (79%) were classified as placebo nonresponders and 76 patients (21%) as placebo responders. Subsequently, patients were randomized within each group to receive either BoNT-A or placebo. In the placebo nonresponder stratum, the mean number of headache-free days at baseline was 5.8 (+/-4.7) for BoNT-A- versus 5.5 (+/-4.7) for placebo-treated patients. At day 180, placebo nonresponders treated with BoNT-A had an improved mean change from baseline of 6.7 headache-free days per 30-day period compared to a mean change from baseline of 5.2 headache-free days for placebo-treated patients. The between-group difference of 1.5 headache-free days favored BoNT-A treatment, although the difference between the groups was not statistically significant. However, a statistically significant difference was observed at day 180 endpoint for the secondary efficacy measure. A significantly higher percentage of BoNT-A patients had a decrease from baseline of 50% or greater in the frequency of headache days per 30-day period at day 180 (32.7% vs. 15.0%, P=.027). Also, the mean change from baseline in the frequency of headaches per 30-day period at day 180 was -6.1 for BoNT-A patients vs. -3.1 for the placebo patients (P=.013). Only 4 of 173 BoNT-A patients (2.3%) discontinued the study due to adverse events. The majority of treatment-related adverse events were transient and mild to moderate in severity. CONCLUSIONS: BoNT-A treatment resulted in patients having, on average, approximately seven more (1 week) headache-free days compared to baseline. Although at the primary time point (day 180) the BoNT-A treatment resulted in a 1.5 between-group difference compared to placebo, this difference was not statistically significant. The treatment met secondary efficacy outcome measures, including the percentage of patients experiencing a 50% or more decrease in the frequency of headache days, in addition to statistically significant reductions in headache frequency. BoNT-A was also well tolerated in patients with CDH.

    Title Mri and Neuropsychological Correlates of Dementia in Binswanger's Disease.
    Date December 2003
    Journal Archives of Clinical Neuropsychology : the Official Journal of the National Academy of Neuropsychologists
    Excerpt

    Nuclear magnetic resonance imaging (MRI) has facilitated diagnosis of Binswanger's disease in vivo, which has proven to be a more common disease entity than once believed. These patients generally present with hypertension, progressive dementia, hydrocephalus, gait difficulty, and personality change. A patient is presented with MRI findings of white-matter destruction and subcortical lesions, and with neuropsychological findings of higher-order cognitive impairment but selectively preserved language and visuospatial-perceptual skills. The relationship between the patient's cognitive-behavioral symptoms and the presence of disconnection syndrome is discussed. In addition, the utility of neuropsychological examination is reviewed. Finally, implications for differentiating cortical from subcortical dementia with psychometric test data are discussed.

    Title Association of Internal Carotid Artery Dissection and Chiropractic Manipulation.
    Date August 2003
    Journal The Neurologist
    Excerpt

    BACKGROUND: To determine the relationship between chiropractic manipulative therapy and internal carotid artery dissection, a MEDLINE literature search was performed for the years 1966 through 2000 using the terms internal carotid dissection. Literature that included information concerning causation of ICAD, as well as all case studies and series, was selected for review. REVIEW SUMMARY: In reviewing the cases of internal carotid dissection potentially related to CMT, there were many confounding factors, such as connective tissue aberrations, underlying arteriopathy, or coexistent infection, that obscured any obvious cause-and-effect relationship. To date there are only 13 reported cases of ICAD temporally related to CMT. Most ICADs seem to occur spontaneously and progress from local symptoms of headache and neck pain to cortical ischemic signs. Approximately one third of the reported cases were manipulated by practitioners other than chiropractic physicians, and because of the differential risk related to major differences in training and practice between practitioners who manipulate the spine, it would be inappropriate to compare adverse outcomes between practitioner groups. CONCLUSIONS: The medical literature does not support a clear causal relationship between CMT and ICAD. Reported cases are exceedingly scarce, and none support clear cause and effect.

    Title Neuroimaging in Presumed Primary Headache Disorders.
    Date March 1998
    Journal Seminars in Neurology
    Excerpt

    As routine outpatient neuroimaging became available more than 20 years ago, controversy arose over appropriate selection of patients for computed tomography studies and subsequently magnetic resonance imaging studies. Nowhere is this more apparent than in headache. Because headache is a truly ubiquitous condition with a lifetime prevalence rate reaching 90%, it is clear we cannot scan all patients with headache. Review of the pertinent literature, expert consensus, and a Practice Parameter issued by the American Academy of Neurology all suggest that routine neuroimaging is not necessary in patients with migraine headaches as defined by the International Headache Society criteria. The literature would also support the belief that imaging is not necessary in patients with typical recurrent cluster headaches. However, patients with new-onset headaches, headaches with a progressive course, headaches with a significant change in pattern, headaches that never alternate sides, and headaches associated with any neurologic findings or seizures have a substantially higher likelihood of a secondary cause such as tumor, arteriovenous malformation, or other structural lesion. In these situations, imaging must be considered as part of the workup. Unfortunately, the literature does not provide enough data to make any statistically predictive observations in patients with headaches other than migraine or cluster headache with symptoms but no findings on neurologic examination.

    Title The Utility of Neuroimaging in the Evaluation of Headache in Patients with Normal Neurologic Examinations.
    Date August 1994
    Journal Neurology

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