Clinical Focus


  • Internal Medicine

Academic Appointments


Professional Education


  • Fellowship: Stanford School of Medicine (2021) CA
  • Residency: Mercy Hospital and Medical Ctr (2020) CA
  • Medical Education: University of Southern California Keck School of Medicine (2017) CA

All Publications


  • Protracted headache after COVID-19: A case series of 31 patients from a tertiary headache center. Headache Moskatel, L. S., Smirnoff, L. 2022

    Abstract

    BACKGROUND: Headache can be a prominent feature of Post-Acute Sequelae of SARS-Cov2 infection (PASC) and previous studies have centered around PASC headaches that have resolved within a month of infection.METHODS: We performed a retrospective chart review of 31 adults evaluated at the Stanford Headache Clinic between September 2020 and January 2022 who developed new or worsening headaches after COVID-19 infection that were unresolved at time of evaluation for demographics, medical history, and headache diagnosis.RESULTS: Headache had been present for a mean duration of 7.4±4.8 months after infection. Notably, 25/31 (81%) had a previous history of headache. The specific features of the headache varied considerably, but 23/31 (74%) met International Classification of Headache Disorders, Third Edition (ICHD-3) criteria for migraine, with 20/31 (65%) meeting ICHD-3 criteria for chronic migraine, while only 5/31 (16%) met these criteria before COVID infection. Additionally, full-time employment decreased from 25/31 (81%) to 17/31 (55%). Prior to establishing care at our clinic, 13/18 (72%) of the patients who were started on preventive medications currently indicated for migraine management, reported a decrease in frequency and/or severity of headaches.CONCLUSIONS: Our study presents a group of patients with protracted headache after COVID-19 infection that includes both patients with a previously lower headache burden who largely exhibited chronification from episodic to chronic migraine, as well as patients with no previous history of headache who meet ICHD-3 criteria for headache attributed to a systemic viral illness, mostly with a migrainous phenotype.

    View details for DOI 10.1111/head.14337

    View details for PubMedID 35670231

  • Migraine and Diet: Updates in Understanding. Current neurology and neuroscience reports Moskatel, L. S., Zhang, N. 2022

    Abstract

    PURPOSE OF REVIEW: We explore recent developments in the prevention and treatment of migraine through dietary interventions.RECENT FINDINGS: Healthier diets (defined in multiple ways), meal regularity, and weight loss are associated with decreased headache burden. Specific diets including the ketogenic diet, the low-glycemic index diet, and the DASH diet are supported by modest evidence for the prevention of migraine. Neither a gluten-free diet, in patients without celiac disease, nor elimination diets have sufficient evidence for their routine consideration. Diet remains a crucial, but underexplored, component of comprehensive migraine management. Multiple interventions exist for providers and patients to consider integrating into their treatment plan. Larger studies are needed to support stronger recommendations for utilization of specific dietary interventions for the prevention and treatment of migraine.

    View details for DOI 10.1007/s11910-022-01195-6

    View details for PubMedID 35482279

  • Headache Made SIMPAL: A Simple Mnemonic for the Approach to Headache Evaluation and Migraine Treatment. Pain medicine (Malden, Mass.) Migdal, C. W., Moskatel, L. S., Schuster, N. M. 2021; 22 (3): 754–58

    View details for DOI 10.1093/pm/pnaa429

    View details for PubMedID 33735383

  • Staphylococcus intermedius Brain Abscess as a Complication of Pulmonary Arteriovenous Malformation in a Patient With Hereditary Hemorrhagic Telangiectasia OPEN FORUM INFECTIOUS DISEASES Moskatel, L. S., Vo, J. N., Nayak, K. R., Crum-Cianflone, N. F. 2020; 7 (11): ofaa467

    Abstract

    Staphylococcus intermedius is a rare cause of human infections ranging from skin and soft tissue infections to bacteremia. It is particularly known for its association with exposure to dogs. We report an unusual case of a 73-year-old female with a brain abscess caused by S intermedius who was recently diagnosed with hereditary hemorrhagic telangiectasia and a pulmonary arteriovenous malformation. The patient underwent debridement of the brain abscess followed by a 6-week course of vancomycin and rifampin, after which she made a near complete recovery. This is the first case of a brain abscess in an adult due to S intermedius in the published literature, and we provide a comprehensive review of the literature of all human infections caused by this pathogen and summarize its clinical manifestations, treatment recommendations, and outcomes.

    View details for DOI 10.1093/ofid/ofaa467

    View details for Web of Science ID 000604521300025

    View details for PubMedID 33209954

    View details for PubMedCentralID PMC7652099