The Consultation San Francisco

Dr. Miranda sees patients at his private office in the Laurel Heights neighborhood of San Francisco. After scheduling your consultation, an informational packet will either be mailed or emailed to you with more information about migraine surgery.

On the day of your consultation, you will be asked to fill out a patient questionnaire, which reviews pertinent areas of your medical, surgical and migraine history.

Dr. Miranda prides himself in his dedication to detail and fully understanding each patient’s individual concerns. Because of this, the initial consultation typically takes at least one hour. Dr. Miranda will listen to all your concerns, discuss your options and conduct a physical examination.  The risks and benefits of each procedure will be discussed in detail. 

Your Migraine History

Dr. Miranda will need a detailed account of your migraine history. In particular, he needs to know:

  • Where are your trigger points (where your migraines start)? Common points may include the forehead, temples, eyes or back of the head.
  • How often are your migraine headaches (per day, week or month)?
  • What medications have you used for migraine relief (prescription and over-the-counter)?
  • Have you used Botox for migraine relief? If so, was it successful?

Identification of Trigger Points

  • Your migraine trigger points will be identified by your history and migraine experiences.
  • Botox is often used to confirm trigger points. Botox with Dr. Miranda is not the same as Botox treatment for migraines with a neurologist. A neurologist will typically inject all over rather than localize the injections to one specific site. Dr. Miranda injects Botox into one nerve site at a time to relax the overlying muscle. After the injections, patients are sent home and instructed to keep a detailed migraine journal (provided by Pacific Migraine) to determine which set of injections provide relief.
  • If you are a candidate, the procedure can be booked shortly after all potential trigger points are confirmed or eliminated.