Botox for Headaches & Migraines Practical Course
A focused practical course in the use of botulinum toxin for chronic migraine and tension-type headache, delivered as the PREEMPT-style multi-site protocol with the upper-face Botox component included as a mandatory part of treatment.
For registered medical professionals who want to add a clinically meaningful and well-evidenced headache intervention to their practice, taught with the full injection map and one supervised live treatment.
About this course
Botulinum toxin is one of the few preventative interventions for chronic migraine that is supported by large randomised controlled trials and that has changed practice in headache clinics worldwide. The PREEMPT protocol — a structured 31-injection paradigm across seven head and neck muscle groups — remains the reference treatment, and a clinician who can deliver it confidently provides genuine and durable benefit to a patient population that frequently feels under-served.
This practical course teaches the full PREEMPT-style injection map and the clinical reasoning behind it. It is designed for registered healthcare professionals who already understand the basics of toxin pharmacology and who want to add this protocol to their clinic with proper anatomical fluency, patient selection criteria and complication awareness.
Crucially, this course includes the upper-face Botox component as a mandatory part of the treatment delivered on the day. The PREEMPT protocol always treats the corrugator, procerus, frontalis and temporalis groups in addition to the occipital, cervical paraspinal and trapezius sites, and it is the upper-face confidence that most often differentiates a safe, effective migraine injector from one whose patients return with brow ptosis.
Online theory covers the diagnostic criteria for chronic migraine, the evidence base for botulinum toxin in headache, the dilution and dose conventions, and the complications you must be ready to recognise. The in-clinic practical day is dedicated to one supervised live PREEMPT-style treatment per delegate at our Harley Street facility.
What you will learn
- ICHD diagnostic criteria for chronic migraine and tension-type headache
- Patient selection: who benefits, who does not, when to refer to a neurologist
- The full PREEMPT-style 31-injection map across seven muscle groups
- Mandatory upper-face component: corrugator, procerus, frontalis, temporalis
- Occipitalis, cervical paraspinal and trapezius injection technique
- Standard dilution and dose conventions
- Recognition and management of brow ptosis, neck weakness and dysphagia
- Outcome assessment using validated headache diaries (e.g. HIT-6, MIDAS)
Curriculum
Online theory module
- Headache classification and the chronic migraine phenotype
- Mechanism of botulinum toxin in headache
- Evidence review: PREEMPT 1, PREEMPT 2 and real-world data
- Patient selection and red-flag screening
- Dilution, dose and the 31-injection map
- Complication recognition and stepwise management
- Outcome assessment and re-treatment scheduling
- Consent, photography and longitudinal documentation
In-clinic practical session
- Live patient consultation and headache history-taking
- Marking the upper-face component (mandatory part of the treatment)
- Marking the temporalis, occipitalis, cervical paraspinal and trapezius sites
- Reconstitution and dilution at the working dose
- One full supervised PREEMPT-style treatment per delegate
- Aftercare counselling and review-appointment scheduling
- Debrief and case review
Clinical detail
Why the upper-face component is mandatory
The PREEMPT protocol always includes injection of the corrugator, procerus, frontalis and temporalis muscle groups. The corrugator and procerus contribute to the trigemino-cervical complex that drives migraine sensitisation, and the frontalis and temporalis injection sites produce the visible cosmetic side-effect that patients frequently report as a welcome bonus. We teach the upper-face component as an inseparable part of the treatment, not as an aesthetic add-on.
Patient selection and red flags
Chronic migraine is defined as headache on 15 or more days per month, of which at least 8 have migrainous features, for at least 3 months. We teach the assessment that filters out secondary headache, the medication-overuse headache pattern that needs detoxification first, and the red-flag features that mandate neurology referral before any injection.
The 31-injection map
Seven muscle groups: corrugator, procerus, frontalis, temporalis, occipitalis, cervical paraspinal and trapezius. Specific dose at each site, total dose typically 155 units, with optional follow-the-pain additions to a maximum of 195 units. We teach the marking discipline that makes this protocol reproducible from one cycle to the next.
Complication awareness
Brow ptosis from frontalis-dominant patients, cervical weakness from over-injection of the paraspinal groups, dysphagia from anterior diffusion, and rarely upper-eyelid ptosis from corrugator diffusion. Each is dose- and technique-dependent and largely avoidable. We teach both the prevention and the stepwise response if any occur.
Outcome assessment and re-treatment
Patients should record headache days using a validated diary. Re-treatment is at 12-week intervals. A meaningful response is typically defined as a 50% reduction in headache days; sub-responders should be reviewed for protocol adherence and for an optional second cycle before discontinuation.
Format & timing
This is a short blended course: complete the online theory at your own pace, then attend the in-clinic practical at our Harley Street facility. The practical portion runs approximately one to two hours per candidate, and the total day length is therefore typically two to three hours depending on group size.
Every delegate performs one full supervised treatment on a live model under one-to-one consultant supervision. We deliberately keep numbers small so that nobody observes more than they inject.
Course duration on the day naturally varies based on the number of delegates booked, model availability, and each candidate's pre-existing injecting experience — beginners benefit from longer one-to-one coaching, while experienced injectors progress more quickly.
Who this course is for
- GPs and primary-care clinicians managing patients with chronic migraine
- Dentists and aesthetic doctors with patients who report headache symptoms
- Nurses and prescribing pharmacists in headache or aesthetic services
- Foundation-trained injectors progressing to a clinical Botox indication
Practical training is restricted to registered healthcare professionals. Proof of registration (GMC, GDC, NMC, GPhC or equivalent) is required at booking.
Outcomes & certification
- Confidence to deliver the full PREEMPT-style protocol safely
- A defensible patient-selection and consent workflow
- Certificate of completion + AiCE / CPD points
- Post-course mentor support for case review
- A new clinical revenue stream that genuinely improves patient lives
Pricing & what's included
£950 + VAT
- Full online theory module with lifetime access
- In-clinic practical session at 1 Harley Street
- Live model and consumables
- Toxin units for one full supervised PREEMPT-style treatment
- Mandatory upper-face Botox component included
- Digital certificate and AiCE points
- Post-course mentor support
Frequently asked questions
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