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    3. Neurology
    4. Headache Management Service

    Headache Management Service

    At Mayo Clinic Healthcare, our neurology department offers a specialised headache management service for people living with frequent, severe migraines. Our chronic migraine treatment focuses on preventing attacks through specialist assessment and NICE-approved intravenous therapy.

    Care is led by our Consultant Neurologist Lt Col John P. O'Dwyer, with support from our specialist nursing team, and Dr Jessica Briscoe, GP with extensive experience in dealing with headache and facial pain. 

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    • Our chronic migraine treatment uses VYEPTI infusions, delivered intravenously.

      VYEPTI is a monoclonal antibody that targets calcitonin gene-related peptide (CGRP), a protein involved in triggering the symptoms of a migraine. By blocking the pathway, our treatment can:

      • Reduce the number of days you experience migraines
      • Lessen the severity of attacks
      • Improve your general quality of life

      VYEPTI is given as a scheduled infusion every 12 weeks and specifically aims to prevent migraines, not provide pain relief during an attack.

      Many people notice improvements within days of their first infusion. 

    • Many people referred to this service have tried lifestyle changes, oral medications or other preventive treatments without lasting benefit. If migraine is affecting your work, relationships or quality of life, a specialist migraine assessment may help clarify your options.

      Usually, we offer the service to people who:

      • Experience episodic or chronic migraine
      • Have migraine on four or more days per month
      • Have not responded to other treatment or preventative measures
      • Meet our eligibility criteria

      A consultant neurologist from our team will assess whether this chronic migraine treatment is suitable for you. 

    • Unlike tension headaches, migraine symptoms are recurrent and debilitating, often lasting hours or days. Symptoms may include: 

      • Nausea and/or vomiting
      • Throbbing or pulsating pain in the head
      • Sensitivity to light or sound
      • Dizziness
      • Blurred vision
      • Neck or body aches

      If you are suffering from the above symptoms and they are affecting your day-to-day life, chronic migraine treatment can help. 

    • We cannot offer the chronic migraine management service if you: 

      • Are pregnant (or planning pregnancy within the next 6 months)
      • Are breastfeeding
      • Are under 18
      • Have hereditary fructose intolerance
      • Have known hypersensitivity to this treatment

      If this applies to you, our specialists can discuss alternative treatment options. Care at Mayo Clinic Healthcare is built on collaboration, and your headache specialist doctor will work closely with their colleagues in our clinics across London and the United States to provide the best possible care for your needs. 

    • Your care with the Mayo Clinic will be personalised to your needs and coordinated with you every step of the way. You can expect:

      • An initial consultation with one of our consultant neurologists or headache specialist doctors
      • A 30-minute IV infusion of VYEPTI, administered by our specialist nursing team
      • Monitoring during and after treatment
      • A nursing follow-up call after five days
      • A consultant review after nine weeks
      • Repeat infusions every twelve weeks
      • A full neurological review after six months

      Infusions take place in our state-of-the-art clinic rooms, fully equipped for IV therapy and emergency response. 

    • If VYEPTI is not suitable for you, there are several other targeted treatments available for headache management. These include:

      • Self-administered monoclonal antibodies targeting CGRP
      • Oral CGRP medications
      • Botox injections
      • Nerve blocks

      Your neurologist or headache specialist will discuss which option may be most appropriate for you. 

    • Botulinum toxin type A (commonly known as Botox) has been used to treat chronic migraine for many years. It is approved for use on the NHS when specific criteria are met.

      We may offer this treatment if you have:

      • Chronic migraine (headache on more than 14 days per month, including at least 8 migraine days)
      • Severe or debilitating migraine, even if you do not meet the full chronic migraine criteria

    • We inject Botox into specific areas around the head and neck. These injection sites have been validated by clinical studies and shown to reduce the frequency and severity of migraine attacks.

      Treatment is usually given every three months. In some cases, the effects can last up to six months.

      The injections are given during a standard clinic appointment. You do not need pain relief or anaesthesia. Most people tolerate the procedure well.

      Some people notice a temporary increase in headache symptoms shortly after treatment. This usually settles.

    • You can return to normal daily activities straight after your appointment. However, we recommend avoiding:

      • Wearing tight hats or headwear for 48 hours
      • Strenuous exercise that causes heavy sweating for 24-48 hours
      • Using a sauna for 24-48 hours

    • We do not routinely offer Botox treatment during pregnancy.

      If you receive Botox for another medical or aesthetic reason, please discuss this with one of our specialists so we can advise you safely.

    • Your treatment will be led by Consultant Neurologist Lt Col John P. O'Dwyer, with our trained nursing staff administering the drug infusion to patients during a 30-minute appointment.

    Private health insurance options

    Mayo Clinic Healthcare works with all major private health insurance providers, including AXA PPP, Aviva, BUPA, Vitality Health and WPA. Self-pay arrangements are also available.

    Our team is always here to answer your questions and guide you through the next steps. 

    Request an appointment today

    If migraines are severely impacting your quality of life, our specialist chronic migraine treatment can help. Book a consultation with us today. 

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    4. Headache Management Service