Botox Treatment for Chronic Migraine

Botox has been used for a number of years to treat chronic migraines headaches. It has been used for this purpose since 2010 when it was granted approval by the Medicines and Healthcare products Regulatory Agency (MHRA). It is not approved or short-term or infrequent migraines and cluster headaches.

What is it?

Botulinum toxin is a neurotoxin that is derived from Clostridium botulinum. There are actually several variations of the substance, with a diluted solution that has become a widely known product for diminishing wrinkles. How it works is that it freezes the muscles by blocking acetylcholine at the neuromuscular junction causing temporary paralysis. It is highly effective at treating muscle spasms which is why it works so well for migraines.

Botulinum toxin and headaches

Botox was not originally intended for the treatment of headaches, but several people who were using it for other things noticed that the frequency of their migraines was greatly reduced when they began treatment. It was first tested on tension headaches but had no real positive results. Several studies later concluded that it was most effective when used in patients with persistent migraine headaches.

The Botox migraine trials

A Phase 3 Research Evaluating Migraine Prophylaxis Therapy (PREEMPT) study was performed using 1,384 migraine sufferers. Participants were given botox and a placebo in a randomized trial for a period of 56 weeks. Of the participants that received Botox injections, they reported having fewer than 8 headache days per month. Prior to the study, participants reported experiencing more than 20 headache days per month. Results were obtained after two injections, by the end of the study, 70% of participants reported only experiencing half as many headache days as before. Side effects were minimal and temporary.

How does botulinum toxin relieve chronic migraines?

The exact mechanism is not known, but in general, Botox works by blocking the impulses to the muscles. In migraine, it is believed that Botox works by blocking the neurotransmitters that trigger migraines.

Is Botox right for you?

Chronic migraine sufferers with at least 15 headache days per month are eligible to receive treatment with Botox. There are other treatments available if you do not qualify, so talk to your doctor to find out about other options available to you.

Who can administer Botox injections?

There is no one designated place to get them. Just make sure that the doctor you choose is properly trained to administer Botox injections and is experienced in managing migraines and follows the PREEMPT guidelines and procedures.

The doctor should take down your medical history, and a full record of when the headaches began, the frequency and intensity, triggers, and any prescription medicines you may have taken before to treat them. You’ll need an accurate diagnosis prior to treatment.