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Botox For Migraine Treatment

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By Jerome Edelstein, MD

Many people have heard about the cosmetic benefits of Botox Cosmetic for smoothing away facial lines and wrinkles. It is one of the most tested, well established medications in Canada and is now approved for many additional, medical applications beyond anti-aging facial injections. Botox and other neuromodulators such as Dysport or Xeomin have proven beneficial for the treatment of excessive underarm, hand and foot sweat.

As well, Botox has been used for a variety of muscle spasm and pain-related issues. One of the most exciting medical applications in Toronto for Botox is chronic migraine treatment. The first migraine medical trials conducted in the 1990’s studied the possible benefits of Botox for headache sufferers after patients reported headache relief following Botox treatments for other reasons.

Initial trials were slightly disappointing as most headache types showed little to no improvement over placebo treatments, however, chronic migraine sufferers benefitted enough to warrant further trials.

Botox (onabotulinum toxin A) was approved for the treatment of chronic migraines in July 2010 by the Medicines and Healthcare products Regulatory Agency (MHRA).

Unfortunately, this doesn’t mean that all types of headaches can be treated successfully with Botox and only chronic migraines are currently approved for this use. Other types of headache such as episodic migraines, tension-type headaches, and cluster headaches may eventually be included with qualifying conditions, but currently, not enough conclusive evidence exists to show benefit with Botox administration and this means medical insurance and health care plans will not cover the cost related to treating these. Botox for migraine relief without medical insurance coverage may cost approximately $10-$15 per unit and a typical migraine dose is 155 units.

BOTOX INJECTION

In a few cases- roughly 6%, neck pain has been reported as a side effect of Botox injection for migraine along with a few other minor issues but no serious irreversible side effects have ever been reported in trials of Botox headache treatment.Relative to other preventative, headache medications such as Topamax and Elavil, Botox does not cause as many side effects. Botox is a prescription medication that is injected to prevent headaches in adults with chronic migraines who have 15 or more days each month with headaches lasting 4 or more hours each day in people 18 years or older.

The benefits of Botox have been well documented – reducing headaches in Migraine sufferers up to 50% – however exactly how and why this works is still somewhat of a medical mystery.

One theory is that the trigeminovascular system, which is a sensory pathway thought to play a key role in the development of a migraine attack, is affected by the Botulinum toxin. In the case of migraine treatment, it is not intended to relax muscles primarily, but to act on nerve function and pain signals specifically.

It is important to consult with a Toronto physician who is experienced in the diagnosis and management of headaches before proceeding with Botox treatment for chronic headaches.

A typical course of treatment would schedule Botox injections every 12 weeks. Often, at least two treatment sessions are required to determine how well a person responds. If no improvement is noted after two sessions it may be that the individual is not responsive to the Botox migraine solution. Generally, each individual may respond differently and doctors may customize the treatment plan accordingly.

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