The Headache and Facial Pain Group is internationally renowned as a centre of clinical and academic excellence for complex headache and facial pain disorders. With a long-standing history of delivering both inpatient and outpatient services unique to the UK, we offer cutting-edge treatments and specialist pathways not widely accessible elsewhere. Focusing exclusively on tertiary referrals, we support patients with intractable headache and facial pain who have already undergone thorough assessment by neurologists across the country.
We run several super-specialist services, including a Neuromodulation Programme, a comprehensive CSF Leak Service, a Complex Facial Pain Clinic and a Trigeminal Autonomic Cephalalgia Service.
Our Neuromodulation Programme is underpinned by a multidisciplinary team of neurologists, neurosurgeons, clinical psychologists and specialist nurses. Every patient is reviewed in a dedicated MDT meeting prior to any intervention, ensuring that indications, device selection and peri-operative care are tailored to individual needs. We are a national leader in Occipital Nerve Stimulation for refractory headache syndromes, and our long-term follow-up combines regular MDT oversight with iterative programming adjustments and outcome monitoring to maximise efficacy and patient satisfaction.
The CSF Leak Service brings together headache neurologists, neuroradiologists and neurosurgeons in a coordinated MDT environment to offer a uniquely comprehensive pathway for cerebrospinal fluid pressure dysregulation disorders. We localise CSF leaks using a comprehensive suite of diagnostics including dynamic CT myelography and digital subtraction myelography and CT myelography. Patients then benefit from the full spectrum of interventions - epidural blood and fibrin patches, endovascular embolisation of CSF-venous fistulas and surgical repair - making us one of the few UK centres able to deliver every available diagnostic and therapeutic option under one roof.
In the Complex Facial Pain Clinic, our neurologists and neurosurgeons co-manage cranial neuralgias and other facial pain disorders. From high-resolution neuroimaging and electrophysiological studies to therapeutic procedures (microvascular decompression, trigeminal internal neurolysis, ablative nerve procedures and Gamma Knife radiosurgery) each care plan is co-developed by the MDT, with specialist nursing support throughout.
Our Trigeminal Autonomic Cephalalgia Service employs detailed phenotyping and rigorous diagnostic protocols, including indomethacin challenge trials, to accurately distinguish trigeminal autonomic cephalalgias. Once a precise diagnosis is confirmed, we deliver targeted pharmacotherapeutic regimens alongside interventional treatments such as cranial nerve blocks, and pioneering neuromodulation approaches.
Where clinically appropriate, patients may also undergo trigeminal ablative or incisional procedures tailored to their individual disorder.
General manager: Natalie Temperley
Assistant general manager: Karen Green
Headache Service
National Hospital for Neurology and Neurosurgery
3rd Floor
8-11, Queen Square
London
WC1N 3BG
Patients must have been seen by their local neurologist before referral to this service. Please complete the headache referral proforma link to avoid delays in appointment allocation and to optimise use of the tertiary appointment.
Where patients have used prophylactic treatments, please could you let us know what was used, the highest dose that was reached and also for how long. See here for the minimum referral information guidance.
E-Referral UCLH Service Name: Headache and Facial Pain Group - Neurology - NHNN – RRV
Headache Service
Box 10, Complex Headache
National Hospital for Neurology and Neurosurgery
London
WC1N 3BG
Primary headaches
- Episodic and chronic migraine (including refractory chronic migraine)
- Cluster headache
- Paroxysmal hemicrania
- Hemicrania continua
- SUNCT/SUNA
- New daily persistent headache
Secondary headaches
- Spontaneous intracranial hypotension/CSF leak
- Idiopathic intracranial hypertension
- Post-traumatic headache
- Medication-overuse headache
- Cervicogenic headache
Facial pain disorders
- Trigeminal neuralgia
- Glossopharyngeal neuralgia
- Other cranial neuralgias (e.g. occipital neuralgia)
- Painful trigeminal neuropathy (including post-herpetic neuralgia)
- Persistent idiopathic facial pain
Inpatient admissions for advanced investigations and treatments
- Indomethacin challenge trials to assess response in specific headache syndromes
- Specialist CSF leak imaging (CT myelography, digital subtraction myelography)
- Specialist CSF leak treatments: non-targeted and targeted epidural blood/fibrin patches; endovascular embolisation; surgical repair
Nerve block procedures
- Greater occipital nerve blocks and multiple cranial nerve blocks
Botulinum toxin injections
- Administered for chronic migraine in eligible patients
CGRP therapies
- Monoclonal antibodies and CGRP antagonist (gepant) treatments for migraine prevention in eligible patients
Dihydroergotamine infusions
- Intravenous dihydroergotamine for refractory headache cases meeting defined clinical criteria
Neuromodulation therapies
- Occipital nerve stimulation for refractory cluster headache and chronic migraine
Trigeminal nerve procedures
- Microvascular decompression and trigeminal internal neurolysis
- Trigeminal ablative procedures - including glycerol rhizolysis, balloon compression, Gamma Knife radiosurgery and radiofrequency ablation - for trigeminal neuralgia and other refractory facial pain conditions
When attending for your appointment please ensure you bring a list of any medications you are on and have tried in the past for your headache.
It would be helpful if this included the doses that were tried, duration and reason it was stopped. It is also helpful to bring in a headache diary which shows how often you are having headaches and how often you are taking painkiller.
Our clinical service is delivered by a multidisciplinary team of six consultant neurologists specialising in headache and facial pain disorders, seven neurosurgeons and four neuroradiologists, supported by an advanced nurse practitioner and ten clinical nurse specialists who coordinate care and patient education.
Clinical psychologists deliver tailored behavioural interventions, while junior doctors oversee assessments and peri-procedural management.
Research fellows drive innovation through clinical trials and outcome audits, translating new findings into practice. This team meets regularly in MDT forums to ensure care is evidence-informed, patient-centred and seamlessly coordinated at every stage.
Migraine videos
