The UAB Department of Neurology has established a new procedure clinic at Cooper Green Mercy Health to expand access to botulinum toxin therapy for issues like migraines, cervical dystonia, and other movement disorders. Until now, patients often traveled to other facilities for injections, adding delays and logistical challenges for people who rely on regular treatment. The new clinic brings these services directly to Cooper Green, making ongoing care easier and more efficient for patients.
For years, UAB Neurology has had a general clinic at Cooper Green, but procedures could not be performed on site.
Rebeka Sipma, M.D.“All our procedures had to be referred to UAB or other outside facilities, which produced additional hurdles for patients,” said Rebeka Sipma, M.D., assistant professor and Director of the Cooper Green Neurology Procedure Clinic. In response, the Department of Neurology partnered with Cooper Green leadership to create a dedicated space equipped for procedure‑based care. The first clinic session was held in July 2025, and beginning in March 2026, the service will expand to a monthly schedule to meet growing needs.
Botulinum toxin injections are approved for various conditions, but the majority of the clinic’s patients come for treatments of chronic migraines. Patients with 15 days or more of headaches per month who have not responded well to oral medications can benefit from the injections.
“Injections every three months can reduce frequency and severity of migraines for patients,” Sipma said.
Part of each visit includes discussing expectations and addressing common concerns.
“Botulinum toxin injections are not just for cosmetic purposes; there are a lot of reasons why we use it in the medical field,” Sipma explained.
The medication does not contain bacteria and cannot cause infection, and its effects gradually wear off, which allows treatment plans to be adjusted over time.
“The effects of the injections are not permanent, so they do have to return every three months for the next round of injections,” she added. “But this also means if they have side effects from the injections, they’re also temporary.”
Meeting other neurologic needs with botulinum toxin therapy
While migraines are a central focus, the clinic also supports several related neurologic needs that benefit from on-site access.
For individuals living with dystonia, timely access is especially important. Dystonia causes involuntary muscle contractions that lead to abnormal neck positioning, tremor‑like movements, and significant discomfort. Botulinum toxin is one of the most effective treatments available, offering great relief for many patients. Sipma noted that physicians, administrators, and pharmacy teams worked together to ensure patients would no longer need multiple steps to receive essential dystonia treatment.
“Botulinum toxin disrupts the nerves’ ability to communicate with the muscle injected, so this allows for reduction in abnormal muscle contractions and pain,” Sipma said. She explained that dystonia often improves after treatment, helping many patients regain comfort, mobility, and daily function.
Patients can also receive botulinum toxin therapy for spasticity, undergo nerve blocks for cervicalgia or occipital neuralgia, and complete lumbar punctures. The space also accommodates visits for neurostimulator interrogation and programming, which often require longer appointments. By providing these services at Cooper Green, patients avoid referrals, multiple appointments, and unnecessary delays in care.
The dedicated procedure clinic also improves efficiency across the neurology service. Housing this work within its own clinic block allows the general neurology clinic to maintain a steady flow of patients.
“This availability in Cooper Green also allows patients to coordinate care at one facility rather than having to go through a referral process, be placed on a waitlist for other local providers, and figure out transportation there,” Sipma said.
Serving as a training site
In addition, the clinic provides hands‑on experience for neurology residents while maintaining its primary mission of improving patient access.
“The residents learn from doing and by walking through their reasoning with an attending,” Sipma said.
For some, early exposure to toxin injections can help shape long‑term career interests.
“In doing toxin injections with movement disorders faculty during residency, I found I loved the more complex thought process involved with determining injection locations and dosing for dystonia, and that led me to fellowship and my career here,” Sipma added.
With the clinic’s expansion to monthly sessions in 2026, patients who rely on Cooper Green for neurologic care will have more consistent access to evidence-based dystonia treatment in a familiar, convenient setting.