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Dr Elliot Shevel addresses negative forum posts and web critics

You may be considering treatment for your headaches or migraines and have come across some negative accounts and comments online about The Headache Clinic or Dr Elliot Shevel.

As with any health and medical treatment, we can never guarantee a hundred percent success for every patient, but we treat on average 100 new patients per month, 80% of which enjoy permanent relief and prevention of their headaches and migraines. These results are without parallel anywhere in the world, and are a very encouraging outcome. Most of our patients regain their quality of life, still headache free years after visiting The Headache Clinic.

Primary headaches, including cluster headache, have been and are exceedingly complex and difficult to treat. The most common factors that affect treatment success at The Headache Clinic are:

  • Foreign patients who do not stay the advised time to complete treatment and for follow up assessments.
  • Local patients who do not come back to the clinic for follow up assessment or treatment.
  • Patients who did not previously disclose medication use, such as opiates, benzodiazapines and sleeping tablet that can negatively affect the results of treatment.
  • And finally and least common, are patients whose particular anatomy makes it too difficult to achieve success.

With all of these scenarios, and each person that does not improve, Dr Shevel and his team never give up, and do their utmost to turn the outcome around. Patients that lose hope before completing treatment are less likely to achieve success. Many of the accounts found online are results of the factors described above and we have disclosed our experience of these incidents below.

Many of our foreign patients have nearly not made the trip to see us based on what they have read online, yet once they returned home with positive results, they have been so grateful that their intuition led them to us regardless.

There are so many ex-cluster or migraine sufferers that have had treatment with us who would be happy to share their experiences with you from a patient perspective. Please contact us at info@headacheclinic.co.za and we will, with their permission, supply their contact details.

If you are contemplating treatment at The Headache Clinic, we invite you to do more research, speak to us and other patients. While we cannot guarantee success we know that we know that we can offer you the highest probability of  being treated successfully and living a pain free, normal, happier life.


  • PC Guy as seen on Cluster Busters
  • Bill55’s complaints on mdjunction
  • Heilette on Cluster Busters
  • Treatment risks and reasons for possible treatment failure
  • Possible post surgery complications
  • Can I contact previous patients
PC Guy as seen on Cluster Busters

Dr Shevel’s response to PC Guy:

PC Guy came from Australia to me for treatment of headache that resulted from a cosmetic laser procedure to the left temple. From the extensive correspondence between us it appeared that his pain was most probably from two sources – arterial and muscular.

I will quote the relevant parts of our correspondence to illustrate what really happened, but the full emails are available if you would like to read them.

On 20th May 2011 he wrote “The diagnosis of injury to the vessel was made based on the following, I have a visible, and pulsatile vessel in my left forehead, (picture attached) that was not in this state prior to the treatment and that lies directly in one of the spots the laser was used”. In the same email he wrote even “if the vessel is responsible there seems to be lot of other stuff going on like muscle pain and stiffness”. Below is the picture he sent me of the damaged artery.

On 5th June 2012 he wrote that he had decided to come to South Africa for treatment. My reply “I have cc ed this e-mail to my practice manager, Nicole Smith, who will assist you with the necessary arrangements. We ask patients to stay for at least two weeks.

He arrived a year later on 20th August 2013, and was scheduled to have the surgery on 21st August 2013. He delayed the surgery until 23rd August, so we lost two days of his trip. On 23rd August he underwent the procedure, which included cauterization of both arteries and muscles. The treatment was discussed in detail with him, and he signed the necessary consent for both muscles and arteries.

Despite our request that patients stay for two weeks after their procedures, he left two days after the surgery but promised that he would return should further procedures be necessary. On 2nd September 2013 he wrote “I will let you know how I am going in a few weeks and see if I need to come back for some more work”.

On 18th October he wrote “are you able to administer the Botox as if so returning to Joburg may be my only option. Please let me know and I am sorry I am so negative”.

I replied the same day saying “Yes, I most certainly am able to give you the Botox – I just hope that it gives you relief from your constant pain.”

I added:

“Did I ever send you the following link for a biofeedback headband that some people find helpful for muscle tension?                http://www.stopgrinding.com/order.htm the one to get is the standard sleepguard system”.

This was intended as an interim measure that may have given him some relief until he returned – clearly any discussion of Botox was aimed at treating muscle tension, so biofeedback for muscle tension could possibly have helped.

Unfortunately he appeared to take umbrage at this, and unleashed a torrent of abuse on various internet sites. Please note that PC Guy is not a cluster headache sufferer, yet he has seen fit to post as if he is on Cluster Busters which is a site devoted to cluster headaches.

His criticisms included:

The difference in the cost of diagnosis between South African patients and foreign patients. With regard to the difference in fees for foreign patients, there are very good reasons:

  • Foreign patients have unlimited access to me and my time for the duration of their stay, as well as with all the other members of my team. There is no other medical facility that I know of that provides the care and service that we do, especially for people who are far from home.
  • Every foreign patient is given a mobile phone with my direct number, so that they are able to contact me at any time of the day or night. They are encouraged to contact me for the slightest problem, and people who have been here for treatment will confirm that I have no hesitation in making house calls to them at all hours if necessary.
  • Because foreign patients are here for a limited period of time, and because they often need follow-up treatment after the first intervention, there is no further charge no matter how much extra treatment has to be administered.
  • The cost also includes a very costly embolization procedure if necessary to close difficult to access arteries. This is also paid to the specialist that does the procedure by the South African patients’ insurance. For foreign patients the total cost includes this.
  • The very expensive CT angiogram scan that we have to take before the surgery is paid for in South Africa by the patient’s medical insurance. Foreign patients have to pay themselves. This is paid to the radiologists who do the scan, and is not part of our fee.

He also wrote on one site that the diagnosis cost 3,500 Australian Dollars and that the surgery cost 8,500 Australian Dollars, totaling 12,000 Australian Dollars. The website is http://www.mdjunction.com/forums/ndph-support-forums/general-support/11040564-surgery-at-the-headache-clinic-johannesburg

On another site though, he claimed that he was charged 20,000 Australian Dollars. https://clusterbusters.org/forums/topic/2898-dr-elliot-shevel/?hl=shevel

He wrote “I have received no support from Dr Shevel or the Clinic in any way. No after care, not even an email other than brief replies to emails I sent following my surgery”. http://www.mdjunction.com/forums/ndph-support-forums/general-support/3650329-claim-for-successful-treatment-for-ndph .

This is also patently not true – we had e-mail contact on a number of occasions – on 29th August 2013, I emailed him (unsolicited) as follows:

Dear Craig,

I hope your flight back was pleasant and uneventful.

The tenderness and soreness of the left temple are most certainly related to the extensive muscle cauterization – this usually subsides in approximately four weeks. The feeling of a tight band should subside as well.

I have not encountered skin numbness before following muscle cautery, but as you have very little subcutaneous fat, some of the small nerves in the skin may have been cauterized when I did the muscle – these will, I have no doubt, recover with time.

If you can find an ointment containing methylsulphonylmethane (also called MSM) and apply it to the tender areas, you may get substantial relief and quicker healing.

How are the spots in the neck that I cauterized?

Best wishes,

Elliot Shevel

I emailed him again on 29th August, 16th September, and 18th September.

It is indeed unfortunate that I was unable to help him – in medical practice it is a fact of life that even with the best will in the world, there will be treatment failures. In this instance though, PC Guy himself played an important part, as he did not stay for the two weeks that was necessary to complete his treatment, and he did not return, as he had promised, for the treatment to be completed. Had he done so, the chances are that he would have had a very positive result.

He claimed that I said there would be no numbness. This is not true, as post-operative numbness of parts of the scalp following arterial surgery is a common occurrence, and all patients are warned beforehand of the possibility.

Below are the sites that we are aware of that PC Guy has posted on:

https://lifemywayblog.wordpress.com/2013/01/03/getting-my-life-back/

https://clusterbusters.org/forums/topic/2898-dr-elliot-shevel/?hl=shevel

http://www.mdjunction.com/forums/ndph-support-forums/general-support/11040564-surgery-at-the-headache-clinic-johannesburg

http://www.mdjunction.com/forums/ndph-support-forums/general-support/11263129-dr-elliot-shevel-in-south-africa

Below is a link to some extensive email correspondence concerning NDPH which may be of interest

http://www.mdjunction.com/forums/ndph-support-forums/general-support/3650329-claim-for-successful-treatment-for-ndph

Bill55’s complaints on mdjunction

Dr Shevel had an extensive correspondence with the person posting as Bill55 on MDJunction from 2011 through to 2013. Bill55 has never visited The Headache Clinic nor been treated by Dr Shevel.

In April 2012 Bill55 wrote, “Thank you very much for your generous reply. As I have said before in this email correspondence, it is to your great credit that you field queries from non-patients and offer detailed replies. Your assistance is an example of the dedicated altruism that, thankfully, still informs the work of many medical doctors”.

In spite of what Bill55 wrote above, the content of his negative comments on MDJUNCTION are of concern.

  1. Bill55: “He (Dr Shevel) has conducted no randomised controlled trials,”

Our Response:

Conducting placebo-controlled trials for surgical procedures is, justifiably, considered highly unethical and not permitted in South Africa. The placebo method is suitable for testing medication, but definitely not for surgery. The concept of conducting surgery for no reason other than to test placebo effect is completely unethical. Theoretically it may sound like a good idea, but for surgery there are other methods of measuring effectivity without performing sham operations. A widely used method is for the patient to do a Quality of Life test before and after the treatment. This is the method that Dr Shevel uses to judge the effectivity of treatment. In 2007 he published a report in the medical journal “Therapy” of 53 patients who underwent arterial surgery for chronic migraine, The average Quality of Life improved dramatically – the paper can be accessed here.

  1. Bill55: “He (Dr Shevel) would argue that scientific progress is a history of overturning convention, but every neurologist I have spoken to about the surgery dismisses it completely. Not one of them found it persuasive. My own neurologist – very eminent in his field – when asked why people would resport to such unproven surgery, simply replied that ‘desperate people will do desperate things.’

Our response:

It is an unfortunate fact that neurologists have limited understanding of the anatomical structures that Dr Shevel treats, from which most migraine pain has been proven to originate. Neurologists are trained to diagnose the brain, spinal chord and nerves, while Dr Shevel examines and treats the extracranial (outside the skull) arteries, and the muscles nerves and tendons of the jaws, head and neck. This is not the fault of the neurologists – the problem is that their specialist training and sphere of expertise does not include the study of these structures.

The only prominent neurologist that we are aware of who has made the effort to find out more is Professor Egilius Spierings, who was previously Professor of Neurology at Harvard Medical School. In 2015 he spent a week with Dr Shevel in Johannesburg with his colleague, Professor Arnaud Vincent, from the Neurosurgery Department at Erasmus University in the Netherlands, to observe first-hand diagnostic and treatment methods used at The Headache Clinic. They were able to observe the stunning results we are achieving. You can find Prof. Spierings’ contact details on the web if you would like confirmation.

  1. Bill55: “Finally, the very high prices that Dr Shevel charges international patients, while not unusual for medical entrepreneurs, is a cause for concern.”

Our response:

With regard to the difference in fees for foreign patients, there are very good reasons:
– Foreign patients have unlimited access to Dr Shevel and his time for the duration of their stay, as well as with all the other members of our team. There is no other medical facility that we know of that provides the care and service that we do, especially for people who are far from home.

– Every foreign patient is given a mobile phone with Dr Shevel’s direct number, so that they are able to contact him personally at any time of the day or night. They are encouraged to contact Dr Shevel for the slightest problem, and people who have been here for treatment will confirm that he has no hesitation in making house calls to them at all hours on any day if necessary.

– Because foreign patients are here for a limited period of time, and because they often need follow-up treatment after the first intervention, there is no further charge no matter how much extra treatment has to be administered. Some patients are complex to treat and require many procedures over a long period of time. These patients have peace of mind that they will not incur extra fees until Dr Shevel has done everything possible to achieve successful results.

– The cost also includes a very costly embolization procedure if necessary to close difficult to access arteries. This is also paid to the specialist that does the procedure by the South African patients’ insurance. For foreign patients the total cost includes this.

– The very expensive CT angiogram scan that we have to have take before the surgery is paid for in South Africa by the patient’s medical insurance. Foreign patients have to pay themselves. The fee for this is paid by us to the radiologists who do the scan, and is not part of our fee.

Heilette on Cluster Busters

Heilette on Cluster Busters:

“I had that operation in September 2012, Dr Shevel did it himself!!! After a month there was noooo relieve, not for even one day!! He asked me to go back and did two arteries again, all I had after that was two numb teeth and I could almost ate only bananas and soup cause I couldn’t open my mouth for a month! It helped zero for me!!!”

Later she posted:

“Don’t  notice anything different after that op until now. The feeling in my teeth are back and I could open my mouth normally after 6 weeks!”

Dr Shevel’s response:

Sadly, Heilette’s surgery was indeed not successful – I was unable to close the maxillary artery despite two attempts due to her particular anatomy.  This is extremely rare.

There is another way of closing the artery, and that is by means of an exceedingly expensive procedure called embolization, which is carried out by a specialist Radiologist. After the second procedure failed, I offered to pay for Heilette to have the embolization done which I believe would have been successful, but as she had understandably lost confidence and she refused this offer.

As of 2017, I have adopted a new medical instrument for my unique cluster headache procedure which has increased my success rates dramatically. Should a patient with the same type of challenging anatomy visit me today, it is most likely that the procedure would be successful and that the unpleasant side effects Heilette experienced would not occur.

Treatment risks and reasons for possible treatment failure

The treatment of primary headaches, which include tension headaches, migraine, and cluster headache, is exceedingly difficult because of a number of factors:

  • The anatomy of the head and neck is the most complex part of the human body, and various structures can be involved in the generation of primary headaches.
  • The problem is further complicated by the fact that each individual’s anatomy is unique. The exact anatomy differs from person to person, and even from side to side in the same individual.
  • In some patients, because the main source of pain overrides other less prominent sources, it is only possible to diagnose these secondary pain centres once the main source of pain has been treated.
  • We know that the main sources of pain in the vast majority of primary headaches are
  1. a) The arteries (small blood vessels) under the scalp, and
  2. b) The muscles of the jaws and neck.
  3. c) The nerves supplying the skin of the scalp.

The most important challenge is to diagnose, in each headache sufferer, from which arteries, muscles, and nerves their headache originates.

  • For this reason time is of the essence – although some cases are relatively easy to treat successfully, in others far more time is necessary to detect and eliminate all the pain centres.
  • In the practice of medicine, and particularly with such complex conditions as primary headaches, one can never guarantee success. The more time that is spent on diagnosis and treatment however, the greater the chances of success.
Possible post surgery complications

Possible post-surgical complications (These complications are rare but possible)

Short-term:

  • Post-operative wound pain and/or swelling.
  • Wound infection.
  • Post-operative nausea.
  • Blurred vision.
  • Loss of skin sensation.
  • Drooping eyebrow.
  • Difficulty in opening mouth, jaw pain, difficulty in chewing.
  • Temporary loss of hair in eyebrow.
  • Light-headedness.
  • Nerve/Scalp sensitivity

Long-term:

  • Sensitive scars.
  • Loss of skin sensation.
  • Scar keloid formation in susceptible individuals.
  • Treatment failure – patient’s condition unchanged.
Can I contact previous patients

Please click here to hear the personal stories of some of our successfully treated patients.

If you would like to contact past patients personally, we have a list of patients from all over the world who have gladly given their permission to be contacted by others contemplating the surgery.

*Treatment results may vary from person to person.

____________________________________

Copyright by The Headache Clinic 2017. All rights reserved.

info@theheadacheclinic.net