Botox Treatment for Chronic Migraines


Botox has gained tremendous fame as cosmetic enhancer therapy for reducing or eliminating crow’s-feet lines, raising droopy eyebrows resulting from sagged skin and frown lines. In 2002, the FDA approved the use of Botox®(Botulinum toxin-A) for the cosmetic purpose of temporarily reducing forehead frown lines. Since then, Botulinum toxin is being tried and tested to give therapeutic benefits to cure diseases; One of them is chronic migraine.

Pain of migraine is very painful and debilitating. Patient may use over the counter drugs or prescription drug to abort the migraine episode or to prevent the onset of migraine episodes, but they all have their own side effects. Preventive therapy with Botox is a relatively newer concept. FDA(2010) has provided approval to Botox treatment as a preventive therapy for chronic migraines.

Botulinum toxin called “miracle poison,” is one of the most poisonous biological substances known.

What is Chronic Migraine?

You can have chronic migraines if:

  • Chronic migraine (CM) is the headache when it occurs more than fifteen days/month for at least three consecutive months, or with headache having the clinical features of migraine with or without aura for at least eight days per month
  • Migraine headache which lasts for four hours a day

What is Botulinum Toxin?

Botulinum toxin is a toxin produced naturally by bacterium Clostridium botulinum which may cause fatal food poisoning if ingested.

But same toxin when given in controlled way in injectable form, has different set of effects which is useful for the preventing treatment of chronic migraines and many other diseases. It temporarily paralyses the muscles to get the desired results.

BoNT/A and /B are the most potent types of Botulinum toxin and have been the only ones approved for clinical use until now.

Two preparations of botulinum toxin A exist:BOTOX® (Allergan Inc., US) and DYSPORT® (Ipsen Ltd, UK) BOTOX® is three times more potent than similar dose of DYSPORT®

BoNT/B is distributed as MYOBLOC® and
NEUROBLOC® in the US and Europe respectively.

What does Botox do in Chronic Migraine Case?

Exactly how Botox treats migraine pain is unknown. Experts believe that Botulinum toxin basically blocks the release of chemicals called as neurotransmitter (substance P, calcitic gene-related peptide CGRP and glutamate) in the brain. These chemicals carry pain signals and Botulinum toxin injections block these chemicals before they enter head and neck region. So, the activation of pain pathway in brain is activated.

What are the Benefits of Botulinum Toxin?

  • OTC or prescription Drugs may have side effects : dizziness, decrease concentration, loss of appetite, weight gain, hair loss and change in libido. Botox is till date has high safety margin and wide therapeutic index.
  • Better compliance as dose schedule is well tolerated
  • Good choice for patients refractory to drugs

Also Read: Botox Training for Career in Cosmetic

How is Botulinum Toxin Given?

  • Shots of botulinum is injected shallow beneath the skin. 31 injections are given for seven areas of head and neck. One Dose is given once in 12 weeks time. Minimum two doses at 12 weeks interval is necessary to get relief in migrainous headaches. Each session may last up-to 20 minutes.
  • Botulinum is injected into special points: bridge of nose, temple, forehead, back of head and neck (most common site) and upper back.

Precautions in Botulinum Treatment

  • You are not fit for Botox if you have episodic migraine history i.e less than 15 days a months or chronic tension type headaches.
  • This is preventive measurement only, cannot abort the headache once you have onset of migraine.
  • Not approved for children below 18 year.
  • Yes, Botox for migraines does work but not for every patient.
  • You may remain symptom free for three to six months, so you will most likely need to get it again after the time has passed.
  • Botox should not be done if you have allergies to any of its ingredients, history muscle or nerve disease, pregnant, breastfeeding or have plans to become pregnant.
  • Not many, but small percentage of patients may experience side effects. Neck pain is the most common. Other side effects: headaches, migraines, slight or partial facial paralysis, eyelids droops, bronchitis, muscle weakness, body stiffness, pain in one or more muscle, ligaments ,tendons and bone, increased blood pressure, muscle spasms, pain at the site of injection.
  • You should get Botox treatment from a doctor who is trained to give these shots  for chronic migraine headache and not wrinkles or other aesthetic application of Botox.

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