The Headache Center of Peachtree Neurological Clinic

We strive to treat each patient as an individual and tailor a treatment plan for you.

Headaches are one of the most common neurological complaints of patients in the primary care setting. Headaches affect millions of Americans and can lead to substantial disability to include missed days at work, strain in relationships, and overall decrease in the quality of life. Our interests include patients with the entire spectrum of headaches, from new onset headaches to chronic longstanding migraines that are refractory to treatment.

The goal of our team is to provide timely diagnosis, treatment, education and satisfaction to our patients. Diagnostic testing, if necessary, is prompt. When appropriate, new and approved treatment for chronic migraine including intravenous and intramuscular treatment is offered. Botox has been recently approved for chronic migraine and is available. Provisions for acute care of the severe or refractory headache patient on the same day is available to hopefully avoid expensive and lengthy ER visits.

At your initial visit, we will gather information regarding your headache, medical history, family history and diagnostic tests. If you have been seen previously by other physicians regarding your headache, please bring your medical records and a copy of the disc and/or report regarding previous diagnostic imaging. We will discuss your type of headache, diagnostic workup, possible triggers, diet, exercise and treatment goals. Some patients find it beneficial to have a list of questions and concerns to be discussed at your appointment. You will be given a headache calendar to track the days, possible triggers and treatment efficacy. You will also be given headache education.

We will attempt outpatient treatment for your headache as our primary goal. On rare occasions, inpatient treatment at Piedmont Hospital may be required.

Please remember to fill out the patient information form(s) with each visit.

  1. Test results will be will be given to patients promptly. Exceptions to this are sleep studies, extensive lab test and biopsy results. Every patient is encouraged to make a follow-up appointment at the time they checkout in order to fully discuss their individual test results and plan of care. You will be notified by staff if critical results are encountered. We will send a consultation letter to your referring physician.
  2. Drug refills should be obtained while you are in the office, if possible. Exceptions to this would include controlled substances which must be called in monthly.
  3. Only under extenuating circumstances will narcotics be called in on the weekends or after hours by the physician on call. Please try to anticipate your refills prior to Friday at 12 Noon.
  4. In order to assure that your drug therapy is appropriate, it is very important for us to see you at least yearly. Please make your appointments early.
  5. Please bring a list of your medications with you at your visit.
  6. All phone calls will be returned in a timely manner. Messages left after 4:00 pm will be answered the next business day.

Faculty and Staff

Dr. Robert Gilbert

Dr. Gilbert received his bachelor of arts degree from Emory University and his medical degree from Duke University. He completed his internship at Duke University and went on to do his residency in Neurology at New York Hospital-Cornell Medical Center. Dr. Gilbert is affiliated with the Piedmont Hospital, where he is a co-director of the Neurophysiology Laboratory. Dr. Gilbert is past president of the Georgia Neurological Society. His medical society memberships include the American Academy of Neurology, American Association of Electromyography and Electrodiagnosis, the American Headache Society, the International Headache Society, Georgia Neurological Society, and the American Society of Neuroimaging. Dr. Gilbert holds certification from the American Association of Electrodiagnostic Medicine and is board certified by the American Board of Psychiatry and Neurology.

Dr. Andrei I. Serbanescu

Dr. Serbanescu received his medical degree from the Carol Davila Medical University School of Medicine in Bucharest, Romania. He completed his internship and residency in neurology at Emory University. He is board certified by the American Board of Psychiatry and Neurology. He has extensive training in neurosurgery, neurology and internal medicine. Dr. Serbanescu comes to us by way of Marietta Neurological Associates, P.C. and Southeast Research Associates and affiliated Headache Clinic. As an investigator for the research firm, he participated in over a dozen studies and tests relating to a range of neurological conditions from Alzheimer’s to seizures. Dr. Serbanescu joined Peachtree Neurological Clinic in 2003 and is on staff at Piedmont Hospital. He also sees patients at the MS Center of Atlanta. He is a member of numerous professional societies, including the American Academy of Neurology, the American Medical Association and the Medical Association of Georgia. He is also UCNS certified in Neuroimaging.

If you would like to make an appointment with one of our physicians in the Headache Center of Peachtree Neurological Clinic, please call 404-351-2270.

Different Types of Headache

Migraine

This type of headache is usually located to one side of the head. Some patients can experience an aura like flashing lights, waterfall vision, lines or dots. Patient can experience symptoms such as slurring speech, numbness, tingling or weakness. These symptoms are often accompanied by nausea or vomiting, light or noise sensitivity and odor sensitivity.

Cluster headaches

Usually occur in men more than women. The headaches are severe in nature, stabbing or sharp, lasting 10 -15 minutes at a time. They are on one side and associated with rhinorrhea or nasal congestion, tearing, eyelid drooping and miosis. These headaches come in clusters and may resolve without recurrence for months or years.

Medication Overuse headache

This headache can occur with frequent use of medication use to treat a headache, such as acetaminophen, caffeine containing products, triptans and ergotamines. Use these products no more than twice weekly.

Tension Headache

This type of headache can be chronic with pain usually to the posterior head, neck and frontal region. Spasms are often noted with this headache as well. This headache usually lacks the features of a migraine although they can sometimes be superimposed.

Headaches can also be the symptom of an underlying problem such as tumors, hemorrhage, vascular abnormalities such as aneurysms, ocular disorders, inflammatory processes like temporal arteritis or other disorders. This is where a thorough neurological exam is most important.

Treatment of Headache

Acute Treatment

medications taken when the headache begins: triptans, ergotamines, steroids, NSAIDs and over the counter preparations.

Preventatives

medications taken to reduce the frequency and severity of attacks: antidepressants, beta-blockers, antiepileptics and recently approved Botox.

Supplements

There is little information or few random controlled trials on the use of supplements and herbal preparations. Some used in the treatment of migraine are: magnesium, riboflavin, CoQ10, feverfew, and butterbur root.

Lifestyle modification

  • Make sure to eat three meals a day.
  • Set realistic goals daily to avoid stress.
  • Get enough sleep but not too much as this can trigger a headache as well.
  • Try to incorporate some sort of exercise on a regular basis.

Common migraine triggers

Common food triggers

  • Deli meat
  • foods with preservatives
  • aged cheeses
  • citrus fruit
  • chocolate
  • red wine

Other common triggers

  • stress
  • barometric weather changes
  • odors
  • too much or too little sleep
  • bright lights.

Patient Forms