Topomax put me in the ER last year so a refused to get back on it when the migraines came back in the fall on top of my IIH. He also wanted to put me on a Beta Blocker which I also refused. That's when he talked to me about nerve blocking which is done by injecting an anesthetic on the nerves going into the craneal area right behind the ears. The effect lasts about 4-5 months and is used to stop the migraines. Has anybody heard of this procedure? It really worked wonders for me.