Medical indication · Zürich Enge
Chronic Migraine
In chronic migraine, preventive treatment can reduce the number and severity of headache days. It does not work during an attack but beforehand — and depends on a clear diagnosis.
This treatment is intended for chronic migraine only — usually defined as at least 15 headache days per month over more than three months, of which at least eight are migraine days. It is not indicated in episodic migraine. The diagnosis is normally established neurologically. Billing is private — treatments cannot be settled through Swiss basic health insurance.
At a glance
- Treatment duration
- 30–45 minutes
- Downtime
- None
- Results visible
- 2–4 weeks
- Result lasts
- About 12 weeks
- From
- CHF 890
Indications
What this treatment is suited for
- Chronic migraine with at least 15 headache days per month
- At least eight of those days with migraine characteristics
- Inadequate response to preventive medication
- Intolerance of or side effects from previous prophylaxis
Mechanism
How the treatment works
Injections are placed into defined muscle groups across the forehead, temples, back of the head, and neck. On current understanding, this reduces the release of pain-transmitting messengers at the nerve endings and raises the threshold at which an attack is triggered. The effect is preventive and builds over weeks.
Procedure
The treatment procedure
The basis is a fixed injection protocol across several muscle groups of the head and neck — considerably more extensive than an aesthetic treatment. A session takes approximately 30 to 45 minutes and is repeated every twelve weeks. Whether the treatment responds can usually only be judged after two full cycles, for which you keep a headache diary between appointments.
Aftercare
After the treatment
Remain upright for a few hours, avoid massaging the treated areas, no sports or sauna on the day of treatment. Continue your headache diary — it is the basis on which we decide about the next session.
Risks and side effects
Pain at the injection sites, neck stiffness, and a temporary sensation of weakness in the neck muscles are the most common side effects. Headache following treatment and temporary drooping of the brow or upper eyelid are also possible.
Contraindications
Not suitable for certain neuromuscular disorders, during pregnancy and breastfeeding, or in the presence of infections in the treatment area. It is not indicated in episodic migraine, where a benefit has not been demonstrated.
Questions about the treatment
Frequently asked questions
When does migraine count as chronic?
Usually at least 15 headache days per month over more than three months, of which at least eight meet the criteria for migraine. Below that threshold the treatment is not indicated — even where the attacks are severe.
Does it also help in episodic migraine?
No. The registration studies showed no benefit in episodic migraine. In that case we do not treat, and discuss in consultation which other routes make sense.
Do I need a diagnosis from a neurologist?
The diagnosis of chronic migraine is normally established neurologically — it is the basis for the treatment being indicated at all. Please bring any existing findings and your headache diary to the first consultation.
How much is injected — and is that included in the price?
The protocol provides for 155 units across 31 injection sites. At the physician's discretion, up to 40 further units may be added where the pain sits strongest. Both are included in the price — we do not bill by quantity. We do not offer a reduced protocol with fewer injection sites, because the benefit is only established for the full one.
This information serves general education and does not replace a personal consultation. Whether a treatment is suitable for you is determined solely in the course of an individual medical consultation. Content medically reviewed by Barbara Matziris.
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Consultation for Chronic Migraine
Whether and to what extent this treatment is suitable for you is clarified in a free initial consultation in our clinic.