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Face Pain and Headaches

Headaches and facial pain can be very complex, with many interrelated causes as well as myriad treatments. Many of these painful conditions require focused research to find new treatments and cures. Sufferers require collaborative, highly specialized expertise to guide their diagnosis and treatment, and the Mischer Neuroscience Institute (MNI) brings together a world-class team of researchers, neurologists, neurosurgeons, and pain management specialists in a center built on quality outcomes and constant innovation.

A collaboration between Memorial Hermann-Texas Medical Center and The University of Texas Health Science Center at Houston (UTHealth) Medical School, MNI is the largest neuroscience program in Texas. MNI integrates neurology, neurosurgery and neurorehabilitation for a comprehensive approach to neurological treatment and care.

Will Erwin Headache Research Center

The Will Erwin Headache Research Center was created with a $20 million pledge over 10 years from the Will Erwin Headache Research Foundation. Led by Mark Burish, M.D., Ph.D., a neurologist who is fellowship trained in interventional pain management, the WEHRC is dedicated to the study of cluster headaches and other debilitating types of headaches. Our goal is to continue to raise funds and ultimately develop a collaborative national consortium of centers committed to understanding and treating chronic headaches.

Dr. Burish received his M.D./Ph.D. in the Medical Scientist Training Program at Vanderbilt University School of Medicine. He completed his residency in neurology at the University of California at San Francisco, where he was co-chief resident of the UCSF Moffitt-Long Service and was inducted into Alpha Omega Alpha Medical Society. He completed his fellowship in interventional pain management in the department of Anesthesiology at UCSF.

The WEHRC represents the Institute’s commitment of energy, talent and research dollars to help people with debilitating headaches recover and participate more fully in life. By continuing to raise funds and by working collaboratively with other researchers across the country, we hope to rapidly impact the lives of patients.

Cluster Headaches

Cluster headaches are rare, affecting about 1 in 1,000 people, and are among the most painful types of headaches people suffer. They are known by more than 10 different names, including histamine headache, migrainous neuralgia and Horton’s headache.

The most prominent characteristic of cluster headache is frequent attacks that may last from weeks to months. These “cluster periods” generally occur in the spring or fall, with headaches often beginning during sleep and lasting between 15 minutes and 3 hours. Some patients do not have these cluster periods and instead have attacks year round.

Cluster headache sufferers awake with intense, burning or stabbing pain on one side of the head, usually around the eye. Other characteristics of cluster headache include:

  • Drooping of the eyelid on the affected side
  • Swelling under or around the eye
  • Watering and redness of one eye
  • Swelling of one side of the face
  • A red, flushed face
  • A runny nostril on the same side as the head pain

Cluster headaches affect more men than women, with the onset generally occurring in adolescence or early middle age. There are a variety of treatments, including triptans, 100 percent oxygen delivered using a facemask, verapamil and lithium, although in a substantial number of patients, none of the treatments are effective. While cluster headaches are not life threatening, they are chronic and painful enough to interfere with daily life and work. 

There are some hereditary causes – cluster headache tends to run in families – and some links to particular molecular pathways and areas of the brain, but the cause of cluster headaches is still unknown.

The Will Erwin Headache Research Center at the Memorial Hermann Mischer Neuroscience Institute is conducting a large-scale study of cluster headache with the goal of characterizing the disease in detail. For more information about the study, please email us or call (713) 704-6900.


Migraine headaches are often described as an intense pulsing or throbbing pain in one area of the head, usually lasting from 4 to 72 hours if left untreated. Other symptoms of this debilitating disorder may include nausea or vomiting and sensitivity to light and sound.

Migraine affects more than 10 percent of people worldwide and is three times more common in women than men. About one-third of migraine sufferers can predict the onset of a migraine because it is preceded by visual disturbances called an “aura,” which may appear as flashing lights, zigzag lines or a temporary loss of vision.

People with migraine tend to have recurring attacks that are triggered by a variety of factors, including stress, hormonal changes, weather changes, lack of food or sleep, and certain types of foods. Researchers now believe that migraine has a genetic cause but its underlying pathophysiology is not fully understood.

Treatment for migraine focuses either on prevention, involving medications and lifestyle changes, and/or on the relief of symptoms. Stress management strategies such as exercise, relaxation techniques and biofeedback may reduce the number and severity of migraine attacks. Hormone therapy may help some women whose migraines seemed to be linked to their menstrual cycle, and they are likely to have fewer attacks and milder symptoms after menopause. For relief of symptoms, sumatriptan, ergotamine drugs and ibuprofen or aspirin may be effective.

With the proper combination of medications for prevention and treatment of migraine attacks, most people can overcome much of the discomfort caused by the disorder.

Face Pain Clinic

At the Face Pain, Trigeminal Neuralgia and Chiari Malformation I Clinic, experienced physicians treat a wide range of complex conditions, including:

Facial Neuralgias

  • Trigeminal neuralgia
  • Atypical facial pain or persistent idiopathic facial pain
  • Anesthesia dolorosa

Other Cranial Neuralgias

  • Glossopharyngeal neuralgia
  • Nervus intermedius or geniculate neuralgia
  • Hemifacial spasm
  • Pain due to tumors of the head and neck
  • Chiari 1 Malformation and Cervical Syrinx

Specialists in Trigeminal Neuralgia and Chiari Malformation

The team at the Clinic is advancing the field in some of the most complex and difficult-to-diagnose conditions that cause face pain, including trigeminal neuralgia (TN) and Chiari I malformation (CM).

Trigeminal neuralgia is a chronic condition that causes extreme facial pain. With unpredictable attacks followed by increasingly brief periods of remission, trigeminal neuralgia is acknowledged by many in the medical field as the most painful condition in existence. Physicians at the Clinic recognize TN’s unique symptomatology and intervene before the condition becomes crippling.

Watch the video below to learn more about trigeminal neuralgia diagnosis and treatment from Dr. Dong Kim, Director of Mischer Neuroscience Institute.


Likewise, the team effectively treats Chiari malformation, a frequently misdiagnosed neurological disorder in which the cerebellum – the part of the brain that controls balance – descends out of the skull into the spinal area. Because Chiari malformation often imitates other neurological conditions, causing symptoms like neck pain, balance issues, muscle weakness and numbness, Chiari malformation sufferers need expert care. View our Chiari Malformation webinar.

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