Dr. Moskatel is internist with fellowship training in headache medicine and board certification in internal medicine. He is a clinical assistant professor in the Stanford University School of Medicine Department of Neurology, Division of Headache.
His practice at the Stanford Health Care Headache Clinic focuses on the diagnosis and treatment of all forms of headache. Patients come to him seeking relief from migraine, cluster, and tension headaches.
Dr. Moskatel teaches headache medicine to medical students and supervises resident physicians in the Stanford Health Care Headache Clinic.
He conducts research into migraine and diet, medication overuse headache, and long-lasting headache after COVID-19. He has written articles on these and other topics. They have appeared in peer-reviewed journals such as Headache, Current Neurology and Neuroscience Reports, Annals of Headache Medicine, and Pain Medicine.
Dr. Moskatel has reviewed the content of articles written by other doctors for the journals Headache and Pain Medicine. The publication Annals of Internal Medicine awarded him a letter of commendation as outstanding reviewer.
He has co-authored textbook chapters on migraine and diet and on headache treatments. He has presented his research discoveries to his peers at meetings of the World Headache Society and other organizations.
Dr. Moskatel volunteers his time to serve both professional and community organizations. He speaks English and Hebrew fluently and reads French.
- Internal Medicine
Clinical Assistant Professor, Neurology & Neurological Sciences
Board Certification: United Council for Neurologic Subspecialties, Headache Medicine (2022)
Board Certification: American Board of Internal Medicine, Internal Medicine (2020)
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
- An exploratory, comparative case series of calcitonin gene-related peptide monoclonal antibodies in migraine patients with rosacea. The British journal of dermatology 2023
The utility of ChatGPT in the assessment of literature on the prevention of migraine: an observational, qualitative study.
Frontiers in neurology
2023; 14: 1225223
It is not known how large language models, such as ChatGPT, can be applied toward the assessment of the efficacy of medications, including in the prevention of migraine, and how it might support those claims with existing medical evidence.We queried ChatGPT-3.5 on the efficacy of 47 medications for the prevention of migraine and then asked it to give citations in support of its assessment. ChatGPT's evaluations were then compared to their FDA approval status for this indication as well as the American Academy of Neurology 2012 evidence-based guidelines for the prevention of migraine. The citations ChatGPT generated for these evaluations were then assessed to see if they were real papers and if they were relevant to the query.ChatGPT affirmed that the 14 medications that have either received FDA approval for prevention of migraine or AAN Grade A/B evidence were effective for migraine. Its assessments of the other 33 medications were unreliable including suggesting possible efficacy for four medications that have never been used for the prevention of migraine. Critically, only 33/115 (29%) of the papers ChatGPT cited were real, while 76/115 (66%) were "hallucinated" not real papers and 6/115 (5%) shared the names of real papers but had not real citations.While ChatGPT produced tailored answers on the efficacy of the queried medications, the results were unreliable and inaccurate because of the overwhelming volume of "hallucinated" articles it generated and cited.
View details for DOI 10.3389/fneur.2023.1225223
View details for PubMedID 37662036
View details for PubMedCentralID PMC10469750
The Role of Step Therapy in the Treatment of Migraine.
Current pain and headache reports
PURPOSE OF REVIEW: This review examines recent evidence and applies bioethical principles to evaluate the benefits and risks of using step therapy in the treatment of migraine.RECENT FINDINGS: With the CGRP mAbs, gepants, and lasmiditan now on the market for up to 5years, new research, including network meta-analyses and long-term use studies, can evaluate the comparative efficacy, tolerability, and adherence of these medications relative to older acute and preventive medications for the treatment of migraine. Deciding how medications are chosen for patients requires accounting for many factors including sustainability, efficacy, tolerability, and preference. Newer research can help give clarity on the appropriateness of gating certain treatment options behind others.
View details for DOI 10.1007/s11916-023-01155-w
View details for PubMedID 37542597
- Real world evidence of changes in CGRP monoclonal antibody and onabotulinumtoxinA prescription practices at the start of the COVID-19 pandemic: An observational, retrospective study. Headache 2023
"The Impact of COVID-19 on Alcohol Sales and Consumption in the United States: a Retrospective, Observational Analysis".
Alcohol (Fayetteville, N.Y.)
Understanding the COVID-19 pandemic's effect on alcohol sales and consumption is critical in mitigating alcohol abuse and morbidity. We sought to determine how the onset of the COVID-19 pandemic and changes in viral incidence affected alcohol sales and consumption in the United States. We conducted a retrospective observational analysis regressing National Institute on Alcohol Abuse and Alcoholism (NIAAA) alcohol sales data and Behavioral Risk Factor Surveillance System (BRFSS) survey data for 14 states for 2017 to 2020 with COVID-19 incidence in 2020 in the United States. The onset of the pandemic was associated with higher monthly alcohol sales per capita of 1.99 standard drinks (95% Confidence Interval: 0.63 to 3.34, p=0.007). Increases of one COVID-19 case per 100 were associated with lower monthly alcohol sales per capita of 2.98 standard drinks (95% CI: -4.47 to -1.48, p=0.001) as well as broad decreases in alcohol consumption, notably 0.17 fewer days per month with alcohol use (95% CI: -0.31 to -0.23, p=0.008) and 0.14 fewer days per month of binge drinking (95% CI: -0.23 to -0.052, p<0.001). The COVID-19 pandemic is associated with increased monthly average alcohol purchases, but higher viral incidence is linked to lower alcohol purchases and consumption. Continued monitoring is needed to mitigate the effects of higher population alcohol use during the pandemic.
View details for DOI 10.1016/j.alcohol.2023.05.003
View details for PubMedID 37230334
- The Impact of COVID-19 Incidence on Emergency Medical Services Utilization. The Journal of emergency medicine 2023
Headache and Dizziness after Roller Coaster Rides: A Case Series of 31 Patients
CANADIAN JOURNAL OF NEUROLOGICAL SCIENCES
Previous literature on roller coaster injuries focuses on catastrophic injuries. We conducted a retrospective study of 31 adults with headache or dizziness after roller coaster rides. Twenty five of 31 (81%) patients presented with new or worsening headache, predominantly migraine (15/25, 60%), including 8/25 (32%) with chronic migraine. Of the chronic migraine patients, 4/8 (50%) already had the diagnosis and presented with an exacerbation. Five of the 25 (20%) were ultimately found to have a cerebrospinal fluid (CSF) leak. While persistent symptoms appear to be relatively rare, patients with chronic migraine and potential CSF leaks should consider skipping these attractions.
View details for DOI 10.1017/cjn.2022.315
View details for Web of Science ID 000896788200001
View details for PubMedID 36329659
Protracted headache after COVID-19: A case series of 31 patients from a tertiary headache center.
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
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.) 2021; 22 (3): 754–58
Staphylococcus intermedius Brain Abscess as a Complication of Pulmonary Arteriovenous Malformation in a Patient With Hereditary Hemorrhagic Telangiectasia
OPEN FORUM INFECTIOUS DISEASES
2020; 7 (11): ofaa467
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