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East Bay Neurology Headache Center

Let's do this together

Our mission here at the Headache Center is to use our specialized training and skills to help patients who suffer from migraines, post-concussive symptoms, and other headache disorders to the best of our ability.

 

We understand that head pain, in any shape or form, can be debilitating. It can interfere with work life, personal relationships, or even doing the things we normally love. We aim to use a multimodal therapeutic approach, including the latest interventions available as well as holistic medicine, to provide a personalized treatment plan that is sustainable and effective. We want people to transform time lost suffering into revitalized energy to live life to the fullest.

We are Board Certified Physicians specifically in Headache Medicine ready to work for you in the path to recovery.

Services Offered:

 

Comprehensive Headache Neurologic Evaluation and Treatment

We offer an extensive, comprehensive headache evaluation that will go over your medical history and investigate all facets of your headache history. Headache forms filled prior to your visit will be reviewed. The evaluation involves doing a complete neurologic examination. Only after we have reviewed your history, performed an examination, and laid out all your present concerns and questions, will we formulate a meaningful, personal treatment plan that is specific to your needs. We will help facilitate additional referrals, labs tests, or imaging we recommend to help elucidate the cause or treat your pain.  At the end of your visit, we will provide you a summary of the treatment plan. In follow-up, we will revisit your headache history, monitor your treatment plan and effectiveness, and make adjustments as needed. We will also address any new concerns or questions that may arise. We understand that headache treatment is very personal and needs to be specialized to your needs for effectiveness, and we constantly tailor and readjust the plan to find the path to recovery and management.

 

Botox Injections For Migraines

Botox is an FDA approved treatment for chronic migraines.

What is Botox?

Botox, or onabotulinum toxin, is actually the toxin produced from a bacteria. It is modified and used in small doses for many medical conditions. Neurologic conditions in which it is used include hemifacial spasms, cervical dystonia, and of course, chronic migraines.

 

People use Botox for migraines?

Yes! The Federal Drug Administration (FDA) approved the use of Botox injections for people suffering with chronic migraines, or people who have migraines/headaches 15 days or more a month.

 

Is Botox right for me?

Botox can be a dramatic and effective alternative modality of treatment for migraines, but depends on each individuals headache pattern and treatment preferences. By receiving periodic injections, sometimes medications can be avoided. Other times it is an adjunctive therapy in addition with pharmacotherapy. We can discuss the risks, benefits, and scientific evidence behind Botox for chronic migraines so you can make the most informed decisions about your headache care.

 

What should I expect?

Should Botox be a possible therapeutic option for you, we will discuss in depth the procedure and expectations before your first treatment. We follow the approved FDA protocol for botox injections. Treatment is repeated once every three months as all effects usually wear off after ninety days. Treatment is usually expected to become more effective with second and third subsequent treatments. 

Why do it here?

Botox is administered by trained Headache Specialists who have done thousands of these injections. We will always adhere to the FDA headache protocol and adjust as needed. Other institutions can cut corners by decreasing the units given or skipping injection sites. Here at East Bay Neurology, we use the original study protocols that have been approved and tailor as needed to your needs.

What should I expect?

Should Botox be a possible therapeutic option for you, we will discuss in depth the procedure and expectations before your first treatment. Treatment is repeated once every three months as all effects usually wear off after ninety days. Treatment is usually expected to become more effective with second and third subsequent treatments.

 

How does it work?

Botox works by blocking signal transmission from the nerve to the muscle, thereby in essence paralyzing the muscle. Although this may play a part in relieving muscle tension that can sometimes be involved with headaches, we now know there are likely more chemical modulatory effects involving the nerves and brain itself in decreasing migraine severity and frequency. Much of this is still being scientifically investigated. 

 

Why does it take so long to get approved by my insurance?

Although Botox is effective, it is an expensive treatment. Most patients will seek insurance authorization although direct pay options for Botox treatments are also available. There are several steps involved, including obtaining authorization, and, if a Specialty Phamracy is involved to deliver your medication, setting of shipment of your medication. The initial authorization process can be initially cumbersome, but we have trained staff specifically to help you navigate this field for expedited treatment. For a reference to the authorization process, please click here.

For more information on Botox for chronic migraines, please visit:

https://www.botoxchronicmigraine.com/

 

Infusion and Injection Clinic

Don't waste time in Urgent Care of the Emergency Room. Get treatment for the headache you are having right now!

The infusion suite is a special room we have designed specifically with our patients in mind. It is a peaceful setting where patients can come and get the infusion and treatments they need in a tranquil environment.

In the infusion suite, patients are given both acute and preventative intravenous or injectable treatments for their headaches.

Having a terrible breakthrough migraine? No problem. You can call our infusion suite for a same day visit and receive acute intravenous or injectable treatments for migraine. By using intravenous and intramuscular medications, we can use stronger medications that are more direct and overall more effective in treating your acute migraine compared to oral medications at home. Total treatment times are usually less than an hour, and by the end of the visit, our goal is to help resolve your headache or bring it to a much more manageable degree to where you can function and carry out your day. Not only is this in the long run cheaper compared to emergency department visits, our regimens are much more effective and are not sedating compared to  medications used in the emergency room or urgent care which often wipe people out. With a smooth process to get you in and out, this is a far more efficient option that will save you a tremendous amount of time compared to waiting around for hours in the emergency room.

Depending on the complexity of your migraines and headaches, we also have infusion protocols designed to help prevent headaches in the future.  As people have a series of infusions over several months, many have noticed a decrease in the severity of their headaches, and have also found their home medications regimens for headache to be much more effective. Please inquire for further details regarding this program.

 

Nerve Injections

 

Various superficial nerves in the head and neck can, when irritated, play a close role in triggering migraines and headaches.  The most common is the occipital nerve, but there are several other nerves that can be involved as well. As headache specialists, we specialize using these nerves as therapeutic targets for mitigating pain. Using specific solutions of anesthetic and anti-inflammatory medications, we perform nerve blocks in these areas with the goal of creating relief that can be sustained.

 

CGRP Inhibitor Migraine Treatments

Over the last several years, there is has been a great degree of research into developing specific preventative migraine medications. The culmination of this research has resulted in the development of 3 novel treatments for migraines in the last year; Aimovig (erenumab), Ajovy (fremanezumab), and Emgality (galcaneumab). These medications are the first medications designed specifically and only for the prevention of migraine, and focus on blocking a body producing substance called calcitonin gene related peptide (CGRP). CGRP is an inflammatory substance that is released in the pain and inflammatory pathways that lead to migraine.

Here at East Bay Neurology we are devoted to staying at the forefront of headache treatment. We are comfortable in describing, prescribing, and monitoring these medications. We likely have the largest practice in the East Bay on these medications and have the largest experience in regards to patient overall satisfaction. Please see us to determine if you would qualify for one of these treatments and to also determine which of these treatments would be best for you.