Headache service
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The Headache Service at St George’s provides a specialist (tertiary) assessment and treatment service for patients with complex headache and facial pain in the South West London and Surrey Region (a population of about 3.2 million).
The service runs six specialist headache outpatient clinics each week providing assessment, investigations, advice and treatment to patients suffering with all forms of disabling headache and facial pain.
In addition the service runs a secondary care headache service (Community Headache Hub, based at Queen Mary’s Hospital, Roehampton) for direct referrals from GPs of patients with headache from the local area (primarily the London Boroughs of Merton and Wandsworth) following a defined care pathway. Please see below under Referrals for more information on the pathway.
Conditions treated include:
- Migraine (episodic and particularly chronic migraine)
- Cluster headache
- Medication-overuse headache
- New daily persistent headache
- Hemicrania continua
- Paroxysmal hemicrania
- SUNCT / SUNA
- Post-traumatic headache
- Secondary headache disorders
Treatments
We use a wide range of treatments, including:
- Lifestyle advice to manage and prevent specific types of headache
- Medications to treat and prevent headaches
- Botulinum toxin therapy for chronic migraine
- Greater occipital nerve blocks
- Multiple cranial nerve blocks
- CGRP monoclonal antibody therapy for migraine
- Non-invasive neurostimulation modalities, such as vagal nerve stimulation, where appropriate
Key staff
The St George’s Headache Service comprises a multidisciplinary team of specialist professionals who work together in complementary roles to care for patients with disabling headache:
The team comprises:
- Dr Niranjanan Nirmalananthan, Consultant Neurologist
- Dr Usman Khan, Consultant Neurologist
- Dr Bhavini Patel, Consultant Neurologist
- Dr Ivy Ong, Consultant Neurologist
- Dr Vic Wallace, Consultant Neurologist
- Dr Rohit Raj, Consultant in Acute Medicine with Specialist Interest in Headache
- Dr Katherine Pink, GP with Specialist Interest in Headache
- Ms Anne-Marie Logan, Consultant Physiotherapist in Headache
- Ms Rebecca Dolling, Senior Physician Associate in Headache
- Ms JuClaire Samson, Headache Nurse Specialist
- Ms Davane Patel, Headache Pathway Coordinator
- Ms Anna Jones, Secretary to the Headache Service
Referrals
Please visit our Neurosciences Booking and Referral Centre for instructions on how to refer to Neurology.
Information for GPs
A new headache pathway document and referral form have been implemented across South West London from October 2020. These documents aim to improve care for patients who suffer from headache and ensure that they are treated in the right setting at the right time. The referral form has been designed for patients with presumed benign headache disorders and replaces all previous forms in circulation in South West London. Please attach a completed form with e-RS referral.
GPs can access a Webinar on the SW London Headache Pathway with referral and management advice on the hyperlink.
Your appointment
When you first come to the headache service we will need to spend time mapping your medical history so we can get a better understanding of what could be causing your headaches, and how best to treat them.
Mapping your medical history can be a long and complex task. To make the process easier, it is helpful if you can:
- keep a headache diary with details of how long your headaches last, how painful they are and what medication you take and whether the medication helped or not. You can download a diary below.
- bring as much information about past medical conditions and treatments with you as you can.
